评估荷兰慢性病患者以人为主导的协同护理体验：荷兰 P3CEQ 的验证。
Assessing the experience of person-centred coordinated care of people with chronic conditions in the Netherlands: Validation of the Dutch P3CEQ.
机构信息
Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands.
Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland.
出版信息
Health Expect. 2022 Jun;25(3):1069-1080. doi: 10.1111/hex.13454. Epub 2022 Mar 23.
BACKGROUND
Countries are adapting their health and social care systems to better meet the needs of growing populations with (multiple) chronic conditions. To guide this process, assessment of the 'patient experience' is becoming increasingly important. For this purpose, the Person-Centred Coordinated Care Experience Questionnaire (P3CEQ) was developed in the United Kingdom, and translated into several languages.
AIM
This study aimed to assess the internal and construct validity of the Dutch P3CEQ to capture the experience of person-centred coordinated care of people with chronic conditions in the Netherlands.
PARTICIPANTS AND METHODS
Adults with chronic conditions (N = 1098) completed the Dutch P3CEQ, measures of health literacy and patient activation, and reported the use and perceived quality of care services. Data analysis included Principal Component and reliability analysis (internal validity), analysis of variance and Student's T-tests (construct validity).
RESULTS
The two-component structure found was pretty much the same as in the UK validation study. Sociodemographic correlates also resembled those found in the United Kingdom. Women, persons who were less educated, less health-literate or less activated experienced less person-centred coordinated care. P3CEQ scores correlated positively with general practitioner performance scores and quality ratings of the total care received.
CONCLUSION
The Dutch P3CEQ is a valid instrument to assess the experience of person-centred coordinated care among people with chronic conditions in the Netherlands. Awareness of inequity and more attention to communication skills in professional training are needed to ensure that care professionals better recognize the needs of women, lower educated or less health-literate persons, and improve their experiences of care.
PATIENT CONTRIBUTION
The P3CEQ has been developed in collaboration with a range of stakeholders. Eighteen persons with (multiple) chronic conditions participated as patient representatives and codesign experts in (four) codesign workshops. Other patient representatives participated in cognitive testing of the English-language instrument. The usability of the P3CEQ to capture the experience of person-centred coordinated care of older persons has been examined by interviewing 228 older European service users, including 13 living in the Netherlands, as part of the SUSTAIN project. More than a thousand persons with chronic conditions participated in the validation study of the Dutch P3CEQ.
背景
各国正在调整其卫生和社会保健系统，以更好地满足患有（多种）慢性病的不断增长的人口的需求。为此，越来越重视评估“患者体验”。为此，在英国开发了以患者为中心的协调护理体验问卷（P3CEQ），并翻译成多种语言。
目的
本研究旨在评估荷兰版 P3CEQ 的内部和结构有效性，以了解荷兰慢性病患者以患者为中心的协调护理体验。
参与者和方法
1098 名慢性病成年人完成了荷兰版 P3CEQ、健康素养和患者激活测量以及护理服务的使用和感知质量报告。数据分析包括主成分和可靠性分析（内部有效性）、方差分析和学生 T 检验（结构有效性）。
结果
发现的两成分结构与英国验证研究基本相同。社会人口统计学相关性也与英国的发现相似。女性、受教育程度较低、健康素养较低或激活程度较低的人体验到的以患者为中心的协调护理较少。P3CEQ 评分与全科医生绩效评分和总护理质量评分呈正相关。
结论
荷兰版 P3CEQ 是评估荷兰慢性病患者以患者为中心的协调护理体验的有效工具。需要提高对公平性的认识，并更加关注专业培训中的沟通技巧，以确保护理专业人员更好地了解女性、受教育程度较低或健康素养较低的人的需求，并改善他们的护理体验。
患者贡献
P3CEQ 是与一系列利益相关者合作开发的。18 名（多种）慢性病患者作为患者代表和共同设计专家参加了（四次）共同设计研讨会。其他患者代表参加了英文仪器的认知测试。在 SUSTAIN 项目中，通过采访包括 13 名居住在荷兰在内的 228 名欧洲老年服务用户，研究了 P3CEQ 对捕捉以患者为中心的协调护理体验的可用性。超过 1000 名慢性病患者参加了荷兰版 P3CEQ 的验证研究。
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