ER 7479 SPURBO, University of Western Brittany, Brest, France.
Department of Human Sciences, University of Western Brittany, Brest, France.
BMC Health Serv Res. 2024 Aug 20;24(1):954. doi: 10.1186/s12913-024-11315-2.
The main aim of this study was to build an item bank for assessing the care quality of multi-professional healthcare centers (MPHCC) from the perspective of patients with multimorbidity. This study was part of the QUALSOPRIM (QUALité des SOins PRIMaires; primary healthcare quality) research project to create a psychometrically robust self-administered questionnaire to assess healthcare quality.
First, twelve experts built an item bank using data from a previous qualitative work and a systematic literature review. Second, the validity of each item was assessed in a sample of patients. Adult patients with multimorbidity were recruited from six French MPHCC. Items were assessed based on ceiling effects, the level of missing or neutral responses and patient feedback. Patient feedback was recorded after the item bank completion. Based on results, items were validated, improved, or removed during expert meetings. In case of disagreement the Delphi method was used to reach consensus.
The study sample included 209 outpatients. The most frequent medical conditions were cardiovascular risk factors, cardiovascular diseases and rheumatological conditions. In total, a bank of 109 items classified in nine domains was built. The validity assessment led to the removal of 34 items. Retained items explored a variety of topics related to care quality: availability, accessibility, premises' layout and building, technical care, expertise, organization, relationships with caregivers and communication, involvement and personal relationships.
This study allowed cross-validation of a bank of 75 items, leading to a complete picture of the patient perception of care quality items. Overall, patients were generally satisfied with their care at the MPHCC. Nonetheless, there were still numerous items on subjects for which patients' satisfaction could be improved.
本研究的主要目的是构建一个用于评估多专业医疗保健中心（MPHCC）护理质量的项目库，该研究从多病种患者的角度出发。本研究是 QUALSOPRIM（QUALité des SOins PRIMaires；初级保健质量）研究项目的一部分，旨在创建一个具有心理测量学可靠性的自我管理问卷，以评估医疗保健质量。
首先，十二位专家使用先前的定性研究和系统文献回顾的数据构建了一个项目库。其次，在患者样本中评估了每个项目的有效性。从六个法国 MPHCC 招募了患有多病种的成年患者。根据天花板效应、缺失或中立反应的水平以及患者反馈评估项目。在完成项目库后记录患者反馈。根据结果，在专家会议期间对项目进行验证、改进或删除。如果存在分歧，则使用德尔菲法达成共识。
研究样本包括 209 名门诊患者。最常见的医疗条件是心血管危险因素、心血管疾病和风湿性疾病。共构建了一个包含 109 个项目的银行，分为九个领域。有效性评估导致 34 个项目被删除。保留的项目探讨了与护理质量相关的各种主题：可用性、可及性、场所布局和建筑、技术护理、专业知识、组织、与护理人员的关系和沟通、参与和个人关系。
本研究允许对 75 个项目的银行进行交叉验证，从而全面了解患者对护理质量项目的感知。总体而言，患者对 MPHCC 的护理普遍感到满意。尽管如此，在患者满意度可以提高的主题上仍有许多项目。
