Howie J G, Heaney D J, Maxwell M, Walker J J
University of Edinburgh, Department of General Practice, UK.
Fam Pract. 1998 Apr;15(2):165-71. doi: 10.1093/fampra/15.2.165.
We aimed to compare a new primary care outcome measure-the Patient Enablement Instrument (PEI)-against two established satisfaction measures [the Medical Interview Satisfaction Scale (MISS) and the Consultation Satisfaction Questionnaire (CSQ)]. Specifically, we sought (i) to test whether enablement and satisfaction are related or separate concepts; and (ii) to assess whether the internal consistency of the PEI might be enhanced by the inclusion of items from the satisfaction instruments.
Questionnaire forms containing the three instruments in a variety of combinations were distributed to a total of 818 patients attending for routine surgery consultations in three urban general practices of varying socio-economic mix. The main outcome measures were: scores on the PEI; scores on the CSQ, the MISS and their individual components; rank correlations between scores on the PEI and scores on the CSQ, the MISS and their component subscales; and Cronbach's alpha coefficient for the PEI.
Overall mean scores, expressed as percentages of maximum scores attainable, were 44.1% for the PEI, 76.9% for the CSQ and 77.6% for the MISS. Rank correlations between PEI scores and scores for the complete CSQ and MISS instruments were 0.48 (P < 0.01) and 0.47 (P < 0.01), respectively. Correlations of PEI scores with individual component scores on the CSQ were generally lower and ranged from 0.14 to 0.53; correlations of PEI scored with MISS component scores were also generally lower and ranged from 0.21 to 0.53. Internal consistency of the PEI items (assessed by Cronbach's alpha coefficient) was lowered when items from the CSQ or MISS were added.
The study shows that 'enablement' is a primary care outcome measure which is related to but is different from general satisfaction.
我们旨在将一种新的初级保健结局测量工具——患者赋能工具（PEI）与两种既定的满意度测量工具[医学访谈满意度量表（MISS）和咨询满意度问卷（CSQ）]进行比较。具体而言，我们试图（i）检验赋能与满意度是相关概念还是不同概念；以及（ii）评估纳入满意度工具中的项目是否可提高PEI的内部一致性。
包含这三种工具各种组合的问卷表被分发给在三个社会经济构成各异的城市全科诊所进行常规手术咨询的总共818名患者。主要结局测量指标为：PEI得分；CSQ、MISS得分及其各个组成部分得分；PEI得分与CSQ、MISS得分及其组成子量表得分之间的等级相关性；以及PEI的克朗巴哈α系数。
以可达到的最高分的百分比表示的总体平均得分，PEI为44.1%，CSQ为76.9%，MISS为77.6%。PEI得分与完整的CSQ和MISS工具得分之间的等级相关性分别为0.48（P<0.01）和0.47（P<0.01）。PEI得分与CSQ单个组成部分得分的相关性通常较低，范围为0.14至0.53；PEI得分与MISS组成部分得分的相关性通常也较低，范围为0.21至0.53。当加入CSQ或MISS的项目时，PEI项目的内部一致性（通过克朗巴哈α系数评估）降低。
该研究表明，“赋能”是一种与总体满意度相关但不同的初级保健结局测量指标。
