Research & Innovation, Optimedis AG, Hamburg, Germany
Midwifery Science, Universität zu Lübeck, Lubeck, Germany.
BMJ Open. 2022 Apr 6;12(4):e049237. doi: 10.1136/bmjopen-2021-049237.
To develop and test the validity and reliability of a tool measuring patient experiences with patient safety in ambulatory care that is suitable for routine use in general practitioner and specialist practices.
Instrument development was based on a literature review, a 3-round Delphi survey with a multidisciplinary expert panel and cognitive interviews with patients. The instrument was piloted in 22 practices using a cross-sectional survey. Exploratory (EFA) and confirmatory factor analysis (CFA) were performed to test construct validity. Internal consistency and the ability of the questionnaire to differentiate between selected subgroups and at the level of individual practices was examined.
General practitioner and specialist practices.
Patients aged >18 years seeking care in ambulatory care practices between February and June 2020.
The final ASK-ME-questionnaire consisted of 22 items covering 5 theoretical dimensions. A total of 3042 patients (71.1%) completed the questionnaire. Median item non-response rate was 4.2% (IQR 3.4%-4.7%). EFA yielded 3 factors comprising 14 items explaining 64.8% of the variance representing contributing factors to patient safety incidents. CFA confirmed the factorial structure suggested by EFA. The model fit the data satisfactorily (comparative fit index=0.92, root mean square error of approximation=0.08, standardised root mean square residual=0.08). Internal consistency values ranged from 0.7 to 0.9. Discriminant validity was supported by significant differences between patients of different age and differences in self-reported health status. The factors distinguished well between practices.
The ASK-ME-questionnaire showed good psychometric properties. It is suitable for routine use in patient safety measurement and improvement systems in ambulatory care. Further research is required to adequately assess number and type of experienced events in routine measurements.
开发并验证一种适用于常规使用于全科医生和专科医生诊所的测量门诊患者对患者安全体验的工具的有效性和可靠性。
基于文献回顾、多学科专家小组的 3 轮德尔菲调查和患者认知访谈进行工具开发。该工具在 22 个实践中进行了试点研究，采用横断面调查。进行探索性（EFA）和验证性因素分析（CFA）以测试结构效度。检验内部一致性和问卷区分选择的亚组和个体实践水平的能力。
全科医生和专科医生诊所。
2020 年 2 月至 6 月在门诊医疗实践中寻求医疗的年龄>18 岁的患者。
最终的 ASK-ME-questionnaire 由 22 个项目组成，涵盖 5 个理论维度。共有 3042 名患者（71.1%）完成了问卷。中位数项目无反应率为 4.2%（IQR 3.4%-4.7%）。EFA 产生了包含 14 个项目的 3 个因子，解释了 64.8%的方差，代表导致患者安全事件的因素。CFA 验证了 EFA 建议的因子结构。该模型数据拟合度良好（比较拟合指数=0.92，均方根误差近似值=0.08，标准化均方根残差=0.08）。内部一致性值范围为 0.7 至 0.9。在不同年龄的患者和自我报告的健康状况之间存在显著差异，这支持了判别有效性。该因子很好地区分了不同的实践。
ASK-ME-questionnaire 具有良好的心理测量学特性。它适用于门诊患者安全测量和改进系统的常规使用。需要进一步研究以充分评估常规测量中经历事件的数量和类型。
