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最重要事项调查:一种自我报告的癌症幸存者患者价值观评估工具的测量评估。

The what matters most survey: A measurement evaluation of a self-reported patient values elicitation tool among cancer survivors.

机构信息

Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey VA Medical Center (MEDVAMC), Houston, TX, USA.

Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey VA Medical Center (MEDVAMC), Houston, TX, USA.

出版信息

Patient Educ Couns. 2023 Oct;115:107899. doi: 10.1016/j.pec.2023.107899. Epub 2023 Jul 16.

Abstract

OBJECTIVES

Patients with multiple chronic conditions, especially cancer survivors, face challenges in medical decision making. Previous research demonstrates how patient values can guide medical decisions, however facilitating patient values elicitation remains a challenge. This study aims to evaluate the psychometric properties of and refine the What Matters Most (WMM) Survey, a self-reported values elicitation tool, in a cohort of older veteran cancer survivors.

METHODS

An observational cohort study was conducted to evaluate the psychometric properties of the WMM Survey in older, multimorbid cancer survivors. 262 patients were administered the assessment at two timepoints, between 14 and 30 days apart.

RESULTS

Exploratory factor analyses revealed four factors for assessing healthcare values among older adults with good internal consistency for all factors: Functioning (Cronbach's alpha coefficient, α = 0.88), Enjoying Life (α = 0.79), Connecting (α = 0.84), and Managing Health (α = 0.88). Demographic and clinical characteristics were not uniformly associated with specific healthcare values.

CONCLUSIONS

Future studies are required to refine the proposed assessment and to evaluate its application in a general patient population.

PRACTICE IMPLICATIONS

The WMM Survey is an innovative resource in health values elicitation, allowing for facilitation of patient-clinician communication for whole-person medical approaches and measurement of health values for research.

摘要

目的

患有多种慢性疾病的患者,尤其是癌症幸存者,在医疗决策方面面临挑战。先前的研究表明患者价值观如何指导医疗决策,但促进患者价值观的挖掘仍然是一个挑战。本研究旨在评估在老年退伍军人癌症幸存者队列中,自我报告的价值观挖掘工具——最重要的事情(What Matters Most,WMM)调查的心理测量特性,并对其进行优化。

方法

进行了一项观察性队列研究,以评估 WMM 调查在老年、多病癌症幸存者中的心理测量特性。在 14 至 30 天的间隔内,对 262 名患者进行了两次评估。

结果

探索性因素分析显示,对于评估老年人医疗保健价值观有四个因素,所有因素的内部一致性都很好:功能(克朗巴赫 α 系数,α=0.88)、享受生活(α=0.79)、联系(α=0.84)和管理健康(α=0.88)。人口统计学和临床特征与特定的医疗保健价值观并不完全相关。

结论

需要进一步研究来优化拟议的评估,并评估其在一般患者群体中的应用。

实践意义

WMM 调查是健康价值观挖掘方面的一项创新资源,它允许促进患者与临床医生之间的沟通,以实现整体医疗方法,并测量健康价值观以进行研究。

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