将德克萨斯基督教大学组织变革准备度简短量表（TCU-ORC-SF）改编为南非基层卫生机构使用。

Adaptation of the Texas Christian University Organisational Readiness for Change Short Form (TCU-ORC-SF) for use in primary health facilities in South Africa.

机构信息

Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, South Africa

Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.

出版信息

BMJ Open. 2021 Dec 17;11(12):e047320. doi: 10.1136/bmjopen-2020-047320.

DOI:10.1136/bmjopen-2020-047320

PMID:34921070

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8689126/

Abstract

OBJECTIVES

The Texas Christian University Organisational Readiness for Change Scale (TCU-ORC) assesses factors influencing adoption of evidence-based practices. It has not been validated in low-income and middle-income countries (LMIC). This study assessed its psychometric properties in a South African setting with the aim of adapting it into a shorter measure.

METHODS

This study was conducted in 24 South African primary healthcare clinics in the Western Cape Province. The TCU-ORC and two other measures, the Organisational Readiness to Change Assessment (ORCA) and the Checklist for Assessing Readiness for Implementation (CARI) were administered. The questionnaire was readministered after 2 weeks to obtain data on test-retest reliability. Three hundred and ninety-five surveys were completed: 281 participants completed the first survey, and 118 recompleted the assessments.

RESULTS

We used exploratory factor analysis (EFA) to identify latent dimensions represented in the data. Cronbach's alpha for each subscale was assessed and we examined the extent to which the subscales and total scale scores for the first and retest surveys correlated. Convergent validity was assessed by the correlation coefficient between the TCU-ORC, ORCA and CARI total scale scores. EFA resulted in a three-factor solution. The three subscales proposed are Clinic Organisational Climate (8 items), Motivational Readiness for Change (13 items) and Individual Change Efficacy (5 items) (26 items total). Cronbach's alpha for each subscale was >0.80. The overall shortened scale had a test-retest correlation of r0.80, p<0.01, acceptable convergent validity with the ORCA scale (r=0.56, p<0.05), moderate convergence with the CARI (r39, p0.05) and strong correlation with the original scale (r=0.79, p<0.05).

CONCLUSIONS

This study presents the first psychometric data on the TCU-ORC from an LMIC. The proposed shortened tool may be more feasible for use in LMICs.

TRIAL REGISTRATION NUMBER

Results stage. Project MIND trial. Pan-African Clinical Trials Registry. PACTR201610001825405.

摘要

目的

德克萨斯基督教大学组织变革准备量表（TCU-ORC）评估了影响采用循证实践的因素。它尚未在低收入和中等收入国家（LMIC）得到验证。本研究旨在评估其在南非环境中的心理测量特性，并将其改编为更简短的测量工具。

方法

本研究在西开普省的 24 家南非初级保健诊所进行。TCU-ORC 与另外两个量表，即组织变革准备评估量表（ORCA）和实施准备检查表（CARI）一起进行评估。问卷在两周后重新进行了评估，以获取测试-重测信度的数据。共完成了 395 份调查问卷：281 名参与者完成了第一次调查，118 名参与者重新完成了评估。

结果

我们使用探索性因子分析（EFA）来识别数据中代表的潜在维度。评估了每个分量表的克朗巴赫系数，并检查了第一份和重测调查的分量表和总量表得分之间的相关性。通过 TCU-ORC、ORCA 和 CARI 总量表得分之间的相关系数评估了聚合效度。EFA 产生了三因素解决方案。提出的三个分量表是临床组织氛围（8 项）、变革动机准备（13 项）和个体变革效能（5 项）（共 26 项）。每个分量表的克朗巴赫系数均>0.80。缩短后的总量表具有 r0.80 的重测相关性，p<0.01，与 ORCA 量表具有可接受的聚合效度（r=0.56，p<0.05），与 CARI 量表具有中等相关性（r39，p0.05），与原始量表具有很强的相关性（r=0.79，p<0.05）。