中文版患者治疗和自我管理体验量表（PETS vs. 2.0）：在香港基层医疗中患有多种慢性病患者中的翻译和验证。
The Chinese version of patient experience with treatment and self-management (PETS vs. 2.0): translation and validation in patients with multimorbidity in primary care in Hong Kong.
机构信息
Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
The George Institute for Global Health, University of New South Wales, Sydney, Australia.
出版信息
J Patient Rep Outcomes. 2024 Aug 2;8(1):82. doi: 10.1186/s41687-024-00765-1.
BACKGROUND
Validated and comprehensive tools to measure treatment burden are needed for healthcare professionals to understand the treatment burden of patients in China. The study aimed to translate and validate the Chinese version of Patient Experience with Treatment and Self-management (PETS vs. 2.0) in patients with multimorbidity in primary care.
METHODOLOGY
The translation process of the 60-item PETS vs. 2.0 followed the Functional Assessment of Chronic Illness Therapy (FACIT) Translation, Formatting, and Testing Guidelines. Computer-assisted assessments were conducted in adult primary care patients with multimorbidity from three general out-patient clinics in Hong Kong. A sample of 502 patients completed the assessments from July to December 2023. Internal reliability was examined using Cronbach's alphas for each domain of the PETS vs. 2.0. Concurrent validity was assessed through the correlations between different domains of PETS vs. 2.0 with established measures including quality of life, frailty, and depression. Confirmatory Factor Analysis (CFA) with maximum likelihood method was carried out to assess the construct validity.
RESULTS
The mean age of participants was 64.9 years old and 56.2% were female. Internal consistency reliability was acceptable (alpha ≥ 0.70) for most domains. Higher scores of PETS domains were significantly correlated with worse quality of life, higher level of frailty, and more depressive symptoms (p < 0.05). In CFA, after setting the covariances on the error variances, the adjusted model revealed an acceptable model fit (χ/df = 1.741; root mean square error of approximation (RMSEA) = 0.038; standardized root mean square residual (SRMR) = 0.058; comparative fit index (CFI) = 0.911; Tucker-Lewis Index (TLI) = 0.903). All standardized factor loadings were 0.30 or above. Significant positive correlations between the latent factors were found for all factor pairs (correlation coefficient < 0.8).
CONCLUSIONS
The Chinese version of PETS vs. 2.0 is a reliable and valid tool for assessing the perceived treatment burden in patients with multimorbidity in primary care. All domains and items in the original questionnaires were retained.
背景
为了让医疗保健专业人员了解中国患者的治疗负担，需要使用经过验证的全面工具来衡量治疗负担。本研究旨在翻译并验证用于初级保健中患有多种合并症的患者的治疗体验和自我管理（Patient Experience with Treatment and Self-management，简称 PETS vs. 2.0）的中文版。
方法
60 项 PETS vs. 2.0 的翻译过程遵循功能评估慢性疾病治疗（Functional Assessment of Chronic Illness Therapy，简称 FACIT）翻译、格式和测试指南。计算机辅助评估在香港三家普通门诊的成年初级保健中患有多种合并症的患者中进行。2023 年 7 月至 12 月期间，共有 502 名患者完成了评估。使用 PETS vs. 2.0 的每个领域的 Cronbach's alpha 来检验内部信度。通过不同领域的 PETS vs. 2.0 与包括生活质量、脆弱性和抑郁在内的既定指标之间的相关性来评估同时效度。采用最大似然法进行验证性因子分析（Confirmatory Factor Analysis，简称 CFA）以评估结构效度。
结果
参与者的平均年龄为 64.9 岁，56.2%为女性。大多数领域的内部一致性信度可接受（alpha ≥ 0.70）。PETS 各领域的评分越高，生活质量越差，脆弱性水平越高，抑郁症状越明显（p < 0.05）。在 CFA 中，在设定误差方差的协方差后，调整后的模型显示出可接受的模型拟合度（χ/df = 1.741；近似均方根误差（root mean square error of approximation，简称 RMSEA）= 0.038；标准化均方根残差（standardized root mean square residual，简称 SRMR）= 0.058；比较拟合指数（comparative fit index，简称 CFI）= 0.911；Tucker-Lewis 指数（Tucker-Lewis Index，简称 TLI）= 0.903）。所有标准化因子负荷均在 0.30 或以上。所有因子对之间均存在显著的正相关（相关系数 < 0.8）。
结论
中文版 PETS vs. 2.0 是一种可靠且有效的工具，可用于评估初级保健中患有多种合并症的患者的感知治疗负担。保留了原始问卷中的所有领域和项目。
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