Institute for Patient Safety (IfPS), University Hospital Bonn, Bonn, Germany.
Medical Management Division, University Hospital Bonn, Bonn, Germany.
J Patient Rep Outcomes. 2024 Nov 5;8(1):125. doi: 10.1186/s41687-024-00806-9.
Patients transitioning between different care contexts are at increased risk of experiencing adverse events. In particular, being discharged to home after inpatient treatment involves significant risks. However, there is a lack of valid and internationally comparable assessment tools on patients' experiences of difficulties following hospital discharge. Therefore, this study aimed to adapt and validate the German version of the post-discharge coping difficulty scale (PDCDS-G).
Patients were recruited at a German university hospital. 815 adult patients participated in a self-report survey following an inpatient stay of at least three days. Factorial validity of the PDCDS-G was evaluated via factor analyses. Further, examination of measurement invariance was performed. To establish criterion validity, associations with patients' self-reported health status and occurrence of patient safety were determined. Further, group differences regarding patient characteristics, hospitalization factors, and survey-related variables were examined.
Factorial validity of the PDCDS-G was confirmed by a two-factorial model with good model fit. Both factors showed good to excellent reliability. The two-factor model achieved measurement invariance across all patient characteristics, hospitalization factors, and survey-related variables. Significant relationships with patients' health status and the occurrence of patient safety incidents corroborate criterion validity of the PDCDS-G. Differential associations of the two PDCDS-G factors regarding patient characteristics, hospitalization, and survey-related variables were found.
Construct and criterion validity, as well as the reliability of the PDCDS-G, were verified. Further, instrument's measurement invariance was confirmed allowing use of the scale for the interpretation of group differences and comparisons between studies.
The PDCDS-G provides a validated and comparable patient-reported outcomes measure for patient experiences after hospital discharge to home. The PDCDS-G can be used for patient surveys in quality or patient safety improvement in care transition processes.
在不同的医疗环境之间转换的患者面临更高的不良事件风险。特别是，从住院治疗出院回家会带来很大的风险。然而，目前缺乏针对患者出院后困难经历的有效且具有国际可比性的评估工具。因此，本研究旨在改编并验证德国版出院后应对困难量表（PDCDS-G）。
在一家德国大学医院招募患者。815 名成年患者在住院至少三天后参加了一项自我报告调查。通过因子分析评估 PDCDS-G 的因子有效性。此外，还进行了测量不变性的检验。为了建立效标效度，确定了患者自我报告的健康状况和患者安全事件发生与 PDCDS-G 的关联。进一步，还检查了患者特征、住院因素和调查相关变量的组间差异。
PDCDS-G 的因子有效性通过具有良好模型拟合度的双因子模型得到证实。两个因子的可靠性均较好。双因子模型在所有患者特征、住院因素和调查相关变量上都实现了测量不变性。与患者健康状况和患者安全事件发生的显著关系证实了 PDCDS-G 的效标效度。在患者特征、住院和调查相关变量方面，PDCDS-G 的两个因子存在不同的关联。
验证了 PDCDS-G 的构建和效标效度以及可靠性。此外，还证实了该工具的测量不变性，从而允许使用该量表来解释组间差异和比较研究。
PDCDS-G 为患者出院后回家的体验提供了一种经过验证且可比较的患者报告结局测量工具。PDCDS-G 可用于患者调查，以改善医疗过渡过程中的质量或患者安全。
