Development and validation of a short version of the Assessment of Chronic Illness Care (ACIC) in Dutch disease management programs.
Development and validation of a short version of the Assessment of Chronic Illness Care (ACIC) in Dutch disease management programs.
复制标题
DOI：
10.1186/1477-7525-9-49
复制
发表时间：
2011-07-04
影响因子：
3.6
通讯作者：
Nieboer AP
中科院分区：
文献类型：
--
作者：
Cramm JM;Strating MM;Tsiachristas A;Nieboer AP
在荷兰，慢性病患者在多大程度上得到与慢性护理模式相一致的护理尚不清楚。本研究的主要目的是(1)验证各种疾病管理计划(DMPS)中对荷兰慢性病护理(ACIC)的评估，以及(2)在保持足够的效度、可靠性和对变化的敏感度的同时，缩短由34个项目组成的ACIC。荷兰版的ACIC在22名DMP和218名专业人员中进行了测试。我们通过结构方程模型对该工具进行了测试，并检验了它的效度、信度和对变化的敏感性。剔除13个项目后，验证性因素分析显示与21个项目的ACIC(ACIC-S)具有良好的拟合指数。Cronbach‘s Alpha所代表的内部一致性从“临床信息系统”子量表的“可接受”到“医疗保健提供系统的组织”子量表的“优秀”不等。ACIC和ACIC-S分量表之间的相关性也很好，范围在0.87到1.00之间，表明CCM的核心区覆盖范围可以接受。7个分量表均呈显著正相关，说明各分量表在概念上是相关的，但也是截然不同的。配对t检验结果显示，在实施DMPS的地区(P<；0.0001的所有组件)，原始工具的Acic分数都随着时间的推移而显著提高。结论：Acic和Acic-S具有较好的心理测量特性，Acic-S是一种很有前途的慢性病护理评估工具。
In the Netherlands the extent to which chronically ill patients receive care congruent with the Chronic Care Model is unknown. The main objectives of this study were to (1) validate the Assessment of Chronic Illness Care (ACIC) in the Netherlands in various Disease Management Programmes (DMPs) and (2) shorten the 34-item ACIC while maintaining adequate validity, reliability, and sensitivity to change. The Dutch version of the ACIC was tested in 22 DMPs with 218 professionals. We tested the instrument by means of structural equation modelling, and examined its validity, reliability and sensitivity to change. After eliminating 13 items, the confirmatory factor analyses revealed good indices of fit with the resulting 21-item ACIC (ACIC-S). Internal consistency as represented by Cronbach's alpha ranged from 'acceptable' for the 'clinical information systems' subscale to 'excellent' for the 'organization of the healthcare delivery system' subscale. Correlations between the ACIC and ACIC-S subscales were also good, ranging from .87 to 1.00, indicating acceptable coverage of the core areas of the CCM. The seven subscales were significantly and positively correlated, indicating that the subscales were conceptually related but also distinct. Paired t-tests results show that the ACIC scores of the original instrument all improved significantly over time in regions that were in the process of implementing DMPs (all components at p < 0.0001). We conclude that the psychometric properties of the ACIC and the ACIC-S are good and the ACIC-S is a promising alternate instrument to assess chronic illness care.