开发一种患者报告结局量表以衡量初级保健中慢性护理会诊的以患者为中心程度。
Development of a PROM to measure patient-centredness in chronic care consultations in primary care.
作者信息
Holm Anne, Lyhnebeck Anna Bernhardt, Buhl Sussi Friis, Bissenbakker Kristine, Kristensen Jette Kolding, Møller Anne, Prior Anders, Kamper-Jørgensen Zaza, Böcher Sidsel, Kristensen Mads Aage Toft, Waagepetersen Asger, Dalsgaard Anders Hye, Siersma Volkert, Guassora Ann Dorrit, Brodersen John Brandt
机构信息
Department of Public Health, Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark.
Department of Public Health, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark.
出版信息
Health Qual Life Outcomes. 2025 Jan 8;23(1):4. doi: 10.1186/s12955-024-02327-x.
INTRODUCTION
Validated patient-reported outcome measures (PROMs) are crucial for assessing patients' experiences in the healthcare system. Both clinically and theoretically, patient-centered consultations are essential in patient-care, and are often suggested as the optimal strategy in caring for patients with multimorbidity.
AIM
To either identify or develop and validate a patient-reported outcome measure (PROM) to assess patient-centredness in consultations for patients with multimorbidity in general practice.
METHODS
We attempted to identify an existing PROM through a systematic literature review. If a suitable PROM was not identified, we planned to (1) construct a draft PROM based on items from existing PROMs, (2) conduct group and individual interviews among members of the target population to ensure comprehensibility, comprehensiveness and relevance, and (3) perform a psychometric validation in a broad sample of patients from primary care.
RESULTS
We did not identify an eligible PROM in the literature review. The item extraction and face validity meetings resulted in a new PROM consisting of 47 items divided into five domains: biopsychosocial perspective; `patient-as-person'; sharing power and responsibility; therapeutic alliance; and coordinated care. The interviews resulted in a number of changes to the layout and phrasing as well as the deletion of items. The PROM used in the psychometric validation consisted of 28 items. Psychometric validation showed high internal consistency, overall high reliability, and moderate fit indices in the confirmatory factor analysis for all five domains. Few items demonstrated differential item functioning concerning variables such as age, sex, and education.
CONCLUSIONS
This study successfully developed and validated a PROM to measure patient-centredness in consultations for patients with multimorbidity. The five domains demonstrated high reliability and validity, making it a valuable tool for measuring patient-centredness of consultations in general practice.
TRIAL REGISTRATION
Trial registration number (data for psychometric validation): https://clinicaltrials.gov : NCT05676541 Registration Date: 2022-12-16.
引言
经过验证的患者报告结局指标（PROMs）对于评估患者在医疗系统中的体验至关重要。在临床和理论层面，以患者为中心的会诊在患者护理中必不可少，并且常被视为照顾患有多种疾病患者的最佳策略。
目的
识别或开发并验证一种患者报告结局指标（PROM），以评估全科医疗中针对患有多种疾病患者的会诊中的以患者为中心程度。
方法
我们试图通过系统的文献综述来识别现有的PROM。如果未识别出合适的PROM，我们计划：（1）基于现有PROM的条目构建PROM草案；（2）在目标人群成员中进行小组和个人访谈，以确保其可理解性、全面性和相关性；（3）在来自初级保健的广泛患者样本中进行心理测量学验证。
结果
我们在文献综述中未识别出符合条件的PROM。条目提取和表面效度会议产生了一个新的PROM，由47个条目组成，分为五个领域：生物心理社会视角；“作为个体的患者”；分享权力和责任；治疗联盟；以及协调护理。访谈导致在布局、措辞以及条目的删除方面做出了一些更改。用于心理测量学验证的PROM由28个条目组成。心理测量学验证显示出高内部一致性、总体高可靠性，并且在所有五个领域的验证性因素分析中拟合指数适中。很少有条目在年龄、性别和教育等变量方面表现出差异项目功能。
结论
本研究成功开发并验证了一种用于测量患有多种疾病患者会诊中以患者为中心程度的PROM。这五个领域显示出高可靠性和有效性，使其成为测量全科医疗会诊中以患者为中心程度的有价值工具。
试验注册
试验注册号（心理测量学验证数据）：https://clinicaltrials.gov ：NCT05676541 注册日期：2022年12月16日。
Zotero 插件