痴呆患者瑞士简易阅读综合姑息治疗结局量表的评定者间信度。
Inter-rating reliability of the Swiss easy-read integrated palliative care outcome scale for people with dementia.
机构信息
UNIL, Institute of Higher Education and Research in Healthcare, Lausanne, Switzerland.
HES-So, School of Health Sciences Fribourg, Switzerland.
出版信息
PLoS One. 2023 Aug 2;18(8):e0286557. doi: 10.1371/journal.pone.0286557. eCollection 2023.
BACKGROUND
The Integrated Palliative Care Outcome Scale for People with Dementia is a promising instrument for nursing home quality improvement and research in dementia care. It enables frontline staff in nursing homes to understand and rate the needs and concerns of people with dementia. We recently adapted the measure to include easy language for users from various educational backgrounds.
OBJECTIVES
In this study, we examine the inter-rating reliability of the Integrated Palliative Care Outcome Scale for People with Dementia for frontline staff in nursing homes.
METHODS
In this secondary analysis of an experimental study, 317 frontline staff members in 23 Swiss nursing homes assessed 240 people with dementia from a convenience sample. Reliability for individual items was computed using Fleiss Kappa. Because of the nested nature of the primary data, a generalisability and dependability study was performed for an experimental IPOS-Dem sum score.
RESULTS
The individual Integrated Palliative Care Outcome Scale for People with Dementia items showed kappa values between .38 (95% CI .3-.48) and .15 (95% CI .08-.22). For the experimental IPOS-Dem sum score, a dependability index of .57 was found. The different ratings and time between ratings explain less than 2% of the variance in the sum score. The different nursing homes make up 12% and the people with dementia make up 43% of the sum score variance. The dependability study indicates that an experimental IPOS-Dem sum score could be acceptable for research by averaging two ratings.
CONCLUSION
Limited research has been conducted on the measurement error and reliability of patient-centred outcome measures for people with dementia who are living in nursing homes. The Swiss Easy-Read IPOS-Dem is a promising instrument but requires further improvement to be reliable for research or decision making. Future studies may look at its measurement properties for different rater populations or at different stages of dementia. Furthermore, there is a need to establish the construct validity and internal consistency of the easy-read IPOS-Dem.
背景
《痴呆患者综合姑息治疗结局量表》是一种很有前途的工具，可用于改善疗养院的护理质量和研究痴呆症护理。它使疗养院的一线工作人员能够了解和评估痴呆症患者的需求和关注点。我们最近对该量表进行了改编，使其更易于具有不同教育背景的用户使用。
目的
本研究旨在检验疗养院一线工作人员对《痴呆患者综合姑息治疗结局量表》的评分者间信度。
方法
在这项对一项实验研究的二次分析中，来自瑞士 23 家疗养院的 317 名一线工作人员从方便样本中评估了 240 名痴呆症患者。使用 Fleiss Kappa 计算个体项目的可靠性。由于原始数据的嵌套性质，对实验性 IPOS-Dem 总分进行了可推广性和可靠性研究。
结果
个体《痴呆患者综合姑息治疗结局量表》项目的 Kappa 值在 0.38（95%CI：0.3-0.48）至 0.15（95%CI：0.08-0.22）之间。对于实验性 IPOS-Dem 总分，发现可靠性指数为 0.57。评分和评分之间时间的不同仅解释了总分变异的小于 2%。不同的疗养院占总分变异的 12%，不同的痴呆症患者占总分变异的 43%。可靠性研究表明，通过平均两次评分，实验性 IPOS-Dem 总分可能适用于研究。
结论
针对居住在疗养院的痴呆症患者的以患者为中心的结局测量工具的测量误差和可靠性研究有限。瑞士易读版 IPOS-Dem 是一种很有前途的工具，但需要进一步改进，才能在研究或决策制定中可靠使用。未来的研究可能会针对不同的评分者群体或痴呆症的不同阶段，研究其测量特性。此外，需要确定易读版 IPOS-Dem 的构念效度和内部一致性。
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