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患者-医生互动中的感知疗效(PEPPI):一种针对老年人的工具的验证

Perceived efficacy in patient-physician interactions (PEPPI): validation of an instrument in older persons.

作者信息

Maly R C, Frank J C, Marshall G N, DiMatteo M R, Reuben D B

机构信息

Department of Family Medicine, UCLA School of Medicine, Los Angeles, California 90095-1683, USA.

出版信息

J Am Geriatr Soc. 1998 Jul;46(7):889-94. doi: 10.1111/j.1532-5415.1998.tb02725.x.

Abstract

OBJECTIVE

To develop and validate a brief instrument--the Perceived Efficacy in Patient-Physician Interactions Questionnaire (PEPPI)--to measure older patients' self-efficacy in obtaining medical information and attention to their medical concerns from physicians.

DESIGN

Two consecutive validation surveys.

SETTING

Eleven senior multipurpose centers in Los Angeles County California.

POPULATION

A convenience sample of 163 community-dwelling older persons (Survey 1: n=59, mean age=77.1 years, 76.3% female; Survey 2: n=104, mean age=77.4 years, 57.7% female).

MEASURES

The 10-item PEPPI, subscales of the Patient Satisfaction Questionnaire, the Medical Outcomes Study (MOS) Coping Scale, the Mastery Scale, and global self-reported health and restricted activity days items.

RESULTS

The full 10-item and a 5-item short form of PEFPI demonstrated Cronbach's alphas of 0.91 and 0.83, respectively. PEPPI demonstrated discriminant and convergent validity as hypothesized, correlating negatively with avoidant coping (r=-.27, P=.001) and positively with active coping (r=.17, P=.03) and with patient satisfaction with physician interpersonal manner (r=.49, P < .0001) and communication (r=.51, P < .0001) (values from the overall sample). Further, in the second survey, PEPPI correlated positively with self-reported health (r=.42, P < .0001), education (r = .24, P=.01) and self-mastery (r=.29, P=.01) and negatively with restricted activity days (r=-.25, P=.01). PEPPI-5 demonstrated correlations similar in magnitude, direction, and statistical significance.

CONCLUSION

In either the 5- or 10-item version, PEPPI is a valid and reliable measure of older patients' perceived self-efficacy in interacting with physicians. This instrument may be useful in measuring the impact of empowerment interventions to increase older patients' personal sense of effectiveness in obtaining needed health care.

摘要

目的

开发并验证一种简短工具——医患互动中感知效能问卷(PEPPI),以测量老年患者在从医生处获取医疗信息及医生关注其医疗问题方面的自我效能感。

设计

连续两次验证性调查。

地点

加利福尼亚州洛杉矶县的11个老年多功能中心。

研究对象

163名社区居住老年人的便利样本(调查1:n = 59,平均年龄 = 77.1岁,女性占76.3%;调查2:n = 104,平均年龄 = 77.4岁,女性占57.7%)。

测量指标

包含10个条目的PEPPI、患者满意度问卷子量表、医学结局研究(MOS)应对量表、掌控感量表以及总体自我报告健康状况和受限活动天数项目。

结果

完整的10条目和5条目简版PEFPI的克朗巴哈系数分别为0.91和0.83。PEPPI如假设所示具有区分效度和聚合效度,与回避应对呈负相关(r = -0.27,P = 0.001),与积极应对呈正相关(r = 0.17,P = 0.03),与患者对医生人际态度的满意度呈正相关(r = 0.49,P < 0.0001)以及与沟通呈正相关(r = 0.51,P < 0.0001)(来自总体样本的值)。此外,在第二次调查中,PEPPI与自我报告健康状况呈正相关(r = 0.42,P < 0.0001)、与教育程度呈正相关(r = 0.24,P = 0.01)以及与自我掌控感呈正相关(r = 0.29,P = 0.01),与受限活动天数呈负相关(r = -0.25,P = 0.01)。PEPPI - 5在相关性的大小、方向和统计学显著性方面表现出相似的结果。

结论

无论是5条目还是10条目版本,PEPPI都是测量老年患者在与医生互动中感知自我效能感的有效且可靠的工具。该工具可能有助于测量增强权能干预措施对提高老年患者在获取所需医疗保健方面个人效能感的影响。

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