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以患者为中心的初级保健措施在儿科连续诊疗中的表现。

Performance of the Person Centered Primary Care Measure in Pediatric Continuity Clinic.

机构信息

Department of Pediatrics (SD Ronis), Case Western Reserve University School of Medicine, Cleveland, Ohio; University Hospitals Rainbow Babies and Children's Hospital (SD Ronis and KK Westphaln), Cleveland, Ohio; UH Rainbow Center for Child Health and Policy (SD Ronis), Cleveland, Ohio.

University Hospitals Rainbow Babies and Children's Hospital (SD Ronis and KK Westphaln), Cleveland, Ohio; Department of Bioethics (KK Westphaln), Case Western Reserve University School of Medicine, Cleveland, Ohio.

出版信息

Acad Pediatr. 2021 Aug;21(6):1077-1083. doi: 10.1016/j.acap.2020.12.006. Epub 2020 Dec 24.

Abstract

OBJECTIVE

Improvement efforts in pediatric primary care would benefit from measures that capture families' holistic experience of the practice. We sought to assess the reliability and validity of the new Person-Centered Primary Care Measure (PCPCM) in a pediatric resident continuity clinic serving low-income families.

METHODS

We incorporated the 11-item PCPCM, stems adapted to reflect a parent responding about their child's visit, into a telephone survey of 194 parents presenting for care in October 2019 at a pediatric resident continuity clinic in Cleveland Ohio (64% response rate). We evaluated PCPCM items using factor analysis and Rasch modeling, and assessed associations of the PCPCM with parents' demographics and perceptions of specific elements of their child's care.

RESULTS

In this sample of low-income families, the PCPCM had good reliability (Cronbach's alpha 0.85). All items loaded onto a single factor in principal axes factor analysis. Of the 11 aspects of primary care represented in the scale, "shared experience" was most difficult for parents to endorse in Rasch modeling. All 11 items contributed significantly to the total scale score with corrected item-total correlations >0.4. The PCPCM score was independent of socio demographics and was associated with parent's report that their child's clinician spends enough time with them.

CONCLUSIONS

The PCPCM performs well in a pediatric continuity clinic setting, warranting consideration for its use as a parsimonious parent-reported measure of what patients and clinicians say matters most in pediatric primary care.

摘要

目的

在儿科初级保健中进行改进,需要使用能全面反映家庭对医疗实践体验的措施。本研究旨在评估新的以患者为中心的初级保健措施(PCPCM)在为低收入家庭提供服务的儿科住院医师连续性诊所中的可靠性和有效性。

方法

我们将包含 11 个项目的 PCPCM 与父母对其子女就诊的反应相结合,纳入俄亥俄州克利夫兰市的一家儿科住院医师连续性诊所 2019 年 10 月的 194 名就诊家长的电话调查中(响应率为 64%)。我们使用因子分析和 Rasch 模型评估 PCPCM 项目,并评估 PCPCM 与父母人口统计学特征以及他们对子女护理特定元素的看法之间的关联。

结果

在这个低收入家庭样本中,PCPCM 具有良好的可靠性(Cronbach's alpha 0.85)。在主成分因子分析中,所有项目均加载到一个单一因素上。在该量表代表的 11 个初级保健方面中,“共同体验”在 Rasch 模型中最难得到家长认可。该量表的 11 个方面都对总评分有显著贡献,校正后的项目-总分相关性>0.4。PCPCM 评分与社会人口统计学因素无关,与家长报告他们的孩子的临床医生与他们相处的时间是否足够有关。

结论

PCPCM 在儿科连续性诊所环境中表现良好,值得考虑将其作为一种简洁的家长报告措施,用于衡量患者和临床医生在儿科初级保健中认为最重要的内容。

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