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德国基于证据的精神卫生保健实施的气候:实施气候量表(ICS)的心理计量学研究。

Climate for evidence-based mental health care implementation in Germany: psychometric investigation of the Implementation Climate Scale (ICS).

机构信息

Department of Psychology, Philipps-University of Marburg, Gutenbergstr. 18, 35032, Marburg, Germany.

Department of Psychiatry, University of California, 9500 Gilman Drive (0812), La Jolla, San Diego, CA, 92093-0812, USA.

出版信息

Sci Rep. 2023 Mar 31;13(1):5311. doi: 10.1038/s41598-023-32282-4.

Abstract

Organizational implementation climate is an important construct in implementation research to describe to what extent implementation is expected, supported, and rewarded. Efforts in bridging the research-practice gap by implementing evidence-based practice (EBP) can benefit from consideration of implementation climate. The Implementation Climate Scale (ICS) is a psychometrically strong measure assessing employees' perceptions of the implementation climate. The present cross-sectional study aimed at providing a German translation and investigating its psychometric properties. The translation followed standard procedures for adapting psychometric instruments. German psychotherapists (N = 425) recruited online completed the ICS, the Evidence Based Practice Attitudes Scale (EBPAS-36D) and the Intention Scale for Providers (ISP). We conducted standard item and reliability analyses. Factorial validity was assessed by comparing an independent cluster model of Confirmatory Factorial Analysis (ICM-CFA), a Bifactor CFA, a Second-order CFA and an (Bifactor) Exploratory Structural Equation Model (ESEM). Measurement invariance was tested using multiple-group CFA and ESEM, convergent validity with correlation analysis between the ICS and the ISP subjective norms subscale (ISP-D-SN). The mean item difficulty was p= .47, mean inter-item correlation r = .34, and mean item-total correlation r = .55. The total scale (ω = 0.91) and the subscales (ω = .79-.92) showed acceptable to high internal consistencies. The model fit indices were comparable and acceptable (Second-order CFA: RMSEA [90% CI] = .077 [.069; .085], SRMR = .078, CFI = .93). Multiple-group CFA and ESEM indicated scalar measurement invariance across gender and presence of a psychotherapy license. Psychotherapists in training reported higher educational support for EBP than licensed psychotherapists (T = 2.09, p = .037, d = 0.25). The expected high correlation between the ICS and the ISP-D-SN was found (r = .59, p < .001). Results for the German ICS confirm good psychometric properties including validity.

摘要

组织实施氛围是实施研究中的一个重要构建,用于描述实施的预期程度、支持程度和奖励程度。通过实施基于证据的实践 (EBP) 来缩小研究与实践之间的差距的努力可以从考虑实施氛围中受益。实施气候量表 (ICS) 是一种具有心理测量学优势的测量工具,用于评估员工对实施氛围的看法。本横断面研究旨在提供德语翻译并研究其心理测量学特性。翻译遵循了改编心理测量工具的标准程序。德国心理治疗师(N=425)在线招募并完成了 ICS、基于证据的实践态度量表 (EBPAS-36D) 和提供者意向量表 (ISP)。我们进行了标准的项目和可靠性分析。通过比较独立聚类模型的验证性因素分析(ICM-CFA)、双因素 CFA、二阶 CFA 和(双因素)探索性结构方程模型(ESEM)来评估因子有效性。使用多组 CFA 和 ESEM 测试测量不变性,使用 ICS 与 ISP 主观规范分量表(ISP-D-SN)之间的相关分析评估收敛有效性。平均项目难度为 p=0.47,平均项目间相关性 r=0.34,平均项目-总分相关性 r=0.55。总量表(ω=0.91)和分量表(ω=0.79-0.92)显示出可接受至高的内部一致性。模型拟合指数相当,可接受(二阶 CFA:RMSEA [90%CI] =0.077 [0.069;0.085],SRMR=0.078,CFI=0.93)。多组 CFA 和 ESEM 表明性别和是否有心理治疗执照的测量不变性。接受培训的心理治疗师比持照心理治疗师报告说对 EBP 的教育支持更高(T=2.09,p=0.037,d=0.25)。ICS 与 ISP-D-SN 之间存在预期的高相关性(r=0.59,p<0.001)。德语 ICS 的结果证实了良好的心理测量学特性,包括有效性。

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