Faculty of Public Health, Naresuan University, Muang District, Phitsanulok Province, Thailand.
Boromarajonani College of Nursing, Uttaradit, Faculty of Nursing, Praboromarajchanok Institute, Ministry of Public Health, Nonthaburi, Thailand.
BMC Prim Care. 2023 Feb 27;24(1):55. doi: 10.1186/s12875-023-02013-9.
Evidence shows that interprofessional collaboration (IPC) practice contributes to the quality of health care. However, there are limited instruments to assess IPC in providing primary care in the district health system (DHS) in Thailand. The aim of this study is to develop a valid and reliable instrument to assess the IPC competency of primary care team members in DHSs.
This study was designed as an exploratory mixed methods study. In the qualitative phase, 37 participants, including policymakers, practitioners, and academics with experience in primary care, were involved. Data were analysed using thematic analysis, and trustworthiness was verified by triangulation and peer debriefing. In the quantitative phase, content validity, exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and reliability were conducted, and the final version of the questionnaire was evaluated with 497 participants.
The findings showed an I-CVI range of 0.86-1.00 and S-CVI/UA = 0.87 for 49 items with a 5-point Likert scale. EFA suggested six factors: 1) collaborative teamwork, 2) population- and community-centred care, 3) communication and mutual respect, 4) clarification of roles and responsibilities, 5) interprofessional reflection, and 6) interprofessional values and mixed skills. In the CFA results, the model fit indices were acceptable (CFI = 0.99, RMSEA = 0.049, SRMR = 0.043) or slightly less than the goodness-of-fit values (GFI = 0.84). All subscales showed acceptable Cronbach's alpha values with a range of 0.86-0.94.
The developed IPC competency instrument was confirmed its validity and reliability that contributes to assessing the IPC competency of primary care teams in DHSs. This information provides evidence to support tailored intervention to promote the IPC competency of primary care team work to achieve a common goal.
有证据表明，跨专业合作（IPC）实践有助于提高医疗保健质量。然而，泰国地区卫生系统（DHS）中用于评估初级保健中 IPC 的工具十分有限。本研究旨在开发一种有效的、可靠的工具，以评估 DHS 中初级保健团队成员的 IPC 能力。
本研究设计为探索性混合方法研究。在定性阶段，有 37 名参与者，包括有初级保健经验的政策制定者、从业者和学者，参与了研究。使用主题分析对数据进行分析，并通过三角测量和同行汇报来验证可信度。在定量阶段，进行了内容有效性、探索性因子分析（EFA）、验证性因子分析（CFA）和可靠性分析，使用 497 名参与者对问卷的最终版本进行了评估。
研究结果显示，49 个 5 分制项目的 I-CVI 范围为 0.86-1.00，S-CVI/UA 为 0.87。EFA 提出了六个因素：1）协作团队；2）以人群和社区为中心的护理；3）沟通和相互尊重；4）明确角色和责任；5）跨专业反思；6）跨专业价值观和混合技能。在 CFA 结果中，模型拟合指数是可接受的（CFI=0.99，RMSEA=0.049，SRMR=0.043），或略低于拟合优度值（GFI=0.84）。所有分量表的 Cronbach's alpha 值均在 0.86-0.94 之间，具有可接受的信度。
所开发的 IPC 能力工具得到了验证，其有效性和可靠性有助于评估 DHS 中初级保健团队的 IPC 能力。这些信息为支持有针对性的干预措施提供了证据，以促进初级保健团队工作的 IPC 能力，实现共同目标。
