Tuinte Renée A M, Bull Claudia, Hoonhorst Job M, Akkermans Reinier P, Moors Marie Louise, Ten Oever Jaap, Hulscher Marlies Ejl, Hoogerwerf Jacobien J
Radboud Institute for Health Sciences, Department of Internal Medicine, Radboud Community for Infectious Diseases, Radboudumc, Nijmegen, The Netherlands
Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Emerg Med J. 2025 Jul 29. doi: 10.1136/emermed-2024-214536.
Measuring and evaluating patient experience in the emergency department (ED) is essential for improving the quality of emergency care. However, specific and validated tools to measure patient experience in the ED are lacking in many countries. The aim of this study was therefore to translate and cross-culturally validate the Australian ED Patient-Reported Experience Measure (ED PREM) for the Dutch setting.
A single-centre validation study was conducted in a Dutch academic hospital. Step 1 involved forward and backward translation to produce a Dutch translation of the ED PREM (prototype). Step 2 involved establishing face and content validity of the Dutch prototype through cognitive patient interviews and researcher team consensus meetings. Step 3 involved administering the resultant Dutch pilot ED PREM to an ED population (n=527), to be able to perform psychometric analyses on this sample. Descriptive statistics and item reduction analyses were conducted prior to confirmatory factor analysis (CFA). CFA was used to confirm the structural validity of the Dutch ED PREM, and internal consistency was assessed.
The face and content validity of the prototype Dutch ED PREM was 'good' after 15 cognitive interviews and expert consultation. Over two-thirds of participants (357/527) completed the Dutch pilot ED PREM. Scores were high across all four domains. Several items were removed due to high ceiling effects and a large number of 'not applicable' responses. The final 18-item Dutch ED PREM showed acceptable model fit with CFA (χ(df) 7519.55 (153), p<0.001, Root Mean Square Error of Approximation=0.090, Tucker-Lewis Index=0.942, Comparative Fit Index=0.951, Standardised Root Mean Square Residual=0.035). Internal consistency was high (Cronbach's alpha ranged 0.85-0.97 per domain).
The final 18-item Dutch ED PREM showed good validity and reliability for measuring ED patient experience. It is suitable and feasible for use in clinical practice to assess and improve the person-centredness of emergency care.
测量和评估急诊科患者体验对于提高急诊护理质量至关重要。然而，许多国家缺乏用于测量急诊科患者体验的特定且经过验证的工具。因此，本研究的目的是对澳大利亚急诊科患者报告体验量表（ED PREM）进行翻译，并在荷兰环境中进行跨文化验证。
在一家荷兰学术医院进行了一项单中心验证研究。第一步包括正向和反向翻译，以生成ED PREM的荷兰语翻译（原型）。第二步包括通过患者认知访谈和研究团队共识会议来确定荷兰语原型的表面效度和内容效度。第三步包括将最终的荷兰语试点ED PREM应用于急诊科人群（n = 527），以便能够对该样本进行心理测量分析。在进行验证性因子分析（CFA）之前进行描述性统计和项目缩减分析。CFA用于确认荷兰语ED PREM的结构效度，并评估内部一致性。
经过15次认知访谈和专家咨询后，荷兰语ED PREM原型的表面效度和内容效度为“良好”。超过三分之二的参与者（357/527）完成了荷兰语试点ED PREM。所有四个领域的得分都很高。由于天花板效应过高和大量“不适用”回答，删除了几个项目。最终的18项荷兰语ED PREM在CFA中显示出可接受的模型拟合度（χ(df) 7519.55 (153)，p < 0.001，近似均方根误差 = 0.090，塔克 - 刘易斯指数 = 0.942，比较拟合指数 = 0.951，标准化均方根残差 = 0.035）。内部一致性较高（每个领域的克朗巴哈α系数范围为0.85 - 0.97）。
最终的18项荷兰语ED PREM在测量急诊科患者体验方面显示出良好的效度和信度。它适用于临床实践，可用于评估和提高以患者为中心的急诊护理。
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