Fernandes Sara, Fond Guillaume, Zendjidjian Xavier, Michel Pierre, Baumstarck Karine, Lançon Christophe, Samalin Ludovic, Llorca Pierre-Michel, Coldefy Magali, Auquier Pascal, Boyer Laurent
CEReSS-Health Service Research and Quality of Life Center (UR3279), Aix-Marseille University, 13005 Marseille, France.
Fondation FondaMental, 94000 Créteil, France.
J Clin Med. 2022 Mar 16;11(6):1644. doi: 10.3390/jcm11061644.
Most patient-reported experience measures (PREMs) are paper-based, leading to a high burden for patients and care providers. The aim of this study was to (1) calibrate an item bank to measure patients' experience of respect and dignity for adult patients with serious mental illnesses and (2) develop computerized adaptive testing (CAT) to improve the use of this PREM in routine practice. Patients with schizophrenia, bipolar disorder, and major depressive disorder were enrolled in this multicenter and cross-sectional study. Psychometric analyses were based on classical test and item response theories and included evaluations of unidimensionality, local independence, and monotonicity; calibration and evaluation of model fit; analyses of differential item functioning (DIF); testing of external validity; and finally, CAT development. A total of 458 patients participated in the study. Of the 24 items, 2 highly inter-correlated items were deleted. Factor analysis showed that the remaining items met the unidimensional assumption (RMSEA = 0.054, CFI = 0.988, TLI = 0.986). DIF analyses revealed no biases by sex, age, care setting, or diagnosis. External validity testing has generally supported our assumptions. CAT showed satisfactory accuracy and precision. This work provides a more accurate and flexible measure of patients' experience of respect and dignity than that obtained from standard questionnaires.
大多数患者报告的体验指标（PREMs）都是纸质版的，给患者和医护人员带来了沉重负担。本研究的目的是：（1）校准一个题库，以衡量成年重症精神疾病患者对尊重和尊严的体验；（2）开发计算机自适应测试（CAT），以改善该PREM在日常实践中的应用。患有精神分裂症、双相情感障碍和重度抑郁症的患者参与了这项多中心横断面研究。心理测量分析基于经典测试理论和项目反应理论，包括对单维性、局部独立性和单调性的评估；模型拟合的校准和评估；差异项目功能（DIF）分析；外部效度测试；最后是CAT开发。共有458名患者参与了该研究。在24个项目中，删除了2个高度相关的项目。因子分析表明，其余项目符合单维假设（RMSEA = 0.054，CFI = 0.988，TLI = 0.986）。DIF分析显示，不存在因性别、年龄、护理环境或诊断导致的偏差。外部效度测试总体上支持了我们的假设。CAT显示出令人满意的准确性和精确性。这项工作提供了一种比标准问卷更准确、更灵活的衡量患者对尊重和尊严体验的方法。
