Ekman Nina, Fors Andreas, Moons Philip, Taft Charles
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
BMJ Open. 2025 Apr 17;15(4):e096576. doi: 10.1136/bmjopen-2024-096576.
To assess the inter-rater reliability of the Gothenburg direct observation tool-person-centred care in assessing healthcare professionals' competency in delivering person-centred care (PCC).
Observational, fully-crossed inter-rater reliability study.
The study was conducted between October and December 2022 at the participants' homes or offices.
Six health professionals individually rated 10 video-recorded, simulated consultations against the 53-item, 15-domain tool covering four major areas: PCC activities, clinician manner, clinician skills and PCC goals. Cronbach's α was used to assess internal consistency. Intraclass correlations (ICC) and 95% CI were computed for the domains.
Two domains (planning and documentation and documentation) were excluded from analyses due to insufficient evaluable data. Cronbach's α was acceptable (>0.70) for all evaluated domains. ICC values were high (ICC ≥0.75) for 11 of the 13 domains; however, CIs were generally wide and the lower bounds fell within the good range (ICC=0.60-0.74) for six domains and fair agreement (ICC=0.40-0.59) for the remaining six. The ICC for the domain patient perspective was non-informative due to its wide CIs (ICC=0.74 (0.39-0.92)).
ICC estimates for most domains were comparable to or exceeded those reported for similar direct observation tools for assessing PCC, suggesting that they may reliably be used in, for example, education and quality improvement applications. Reliability for the domains planning and documentation and documentation needs to be assessed in studies sampling more documentation behaviours. Reliability for the patient perspective domain may owe to methodological issues and should be reassessed in larger, better-designed studies.
评估哥德堡直接观察工具——以患者为中心的护理，在评估医疗保健专业人员提供以患者为中心护理（PCC）能力方面的评分者间信度。
观察性、完全交叉评分者间信度研究。
该研究于2022年10月至12月在参与者的家中或办公室进行。
六名卫生专业人员根据涵盖四个主要领域（PCC活动、临床医生态度、临床医生技能和PCC目标）的53项、15个领域的工具，对10段视频记录的模拟会诊进行单独评分。使用Cronbach's α评估内部一致性。计算各领域的组内相关系数（ICC）和95%置信区间（CI）。
由于可评估数据不足，两个领域（计划与记录以及记录）被排除在分析之外。所有评估领域的Cronbach's α均可接受（>0.70）。13个领域中的11个领域的ICC值较高（ICC≥0.75）；然而，置信区间通常较宽，6个领域的下限落在良好范围（ICC=0.60 - 0.74）内，其余6个领域的一致性为中等（ICC=0.40 - 0.59）。由于其置信区间较宽（ICC=0.74（0.39 - 0.92）），患者视角领域的ICC无参考价值。
大多数领域的ICC估计值与用于评估PCC的类似直接观察工具所报告的估计值相当或更高，这表明它们可可靠地用于例如教育和质量改进应用中。计划与记录以及记录领域的信度需要在更多记录行为抽样的研究中进行评估。患者视角领域的信度可能归因于方法学问题，应在更大、设计更好的研究中重新评估。
