Ask, Understand, Remember: A Brief Measure of Patient Communication Self-Efficacy Within Clinical Encounters
Ask, Understand, Remember: A Brief Measure of Patient Communication Self-Efficacy Within Clinical Encounters
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DOI：
10.1080/10810730.2010.500349
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发表时间：
2010-01-01
影响因子：
4.4
通讯作者：
Wolf, Michael S.
中科院分区：
文献类型：
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作者：
Clayman, Marla L.;Pandit, Anjali U.;Wolf, Michael S.
患者与医疗保健提供者有效沟通的能力是适当自我保健的一个重要方面，特别是对于那些患有慢性疾病的患者。我们想要开发并验证一种简短、可靠的临床接触中患者沟通自我效能的测量方法。从伊利诺斯州芝加哥、大急流城、密歇根州和路易斯安那州什里夫波特的7个初级保健诊所连续招募确诊为高血压的患者（n=330），完成了面对面访谈，包括慢性病自我效能、高血压知识、健康素养评估以及从沟通和态度自我效能(CASE) -癌症量表中修改的项目。案例中的6个项目是新量表的候选项目，因为它们关注的是患者与提供者的关系。利用主成分分析和变量旋转，四个项目强烈加载到一个因素（特征值=2.33，方差解释比例=58%），Cronbach系数为0.75。被称为问、理解、记忆评估（AURA）的测量与现有慢性疾病管理自我效能量表的总分（r=0.31）和疾病知识（β系数=0.2,95%置信区间0.04-0.3,p= 0.03）存在中度相关。健康素养低的患者在AURA上的得分低于健康素养较低或足够的患者（p.05）。AURA具有较高的内部一致性，并与高血压知识和慢性疾病自我效能量表相关。AURA简短、有效、读数要求低，是慢性疾病患者使用的合适工具。它也可以用于识别和帮助那些有错误或不遵守自我保健行为风险的患者。
Patients' ability to effectively communicate with their health care providers is an essential aspect of proper self-care, especially for those with chronic conditions. We wanted to develop and validate a brief, reliable measure of patient communication self-efficacy within clinical encounters. Consecutively recruited patients (n=330) with diagnosed hypertension from seven primary care clinics in Chicago, Illinois, Grand Rapids, Michigan, and Shreveport, Louisiana completed an in-person interview including chronic disease self-efficacy, hypertension knowledge, health literacy assessments, and items modified from the Communication and Attitudinal Self-Efficacy (CASE) - Cancer scale. Six items from the CASE were candidates for a new scale due to their focus on the patient-provider relationship. Using principal components analysis with varimax rotation, four items strongly loaded onto one factor (Eigenvalue=2.33; proportion of variance explained=58%) with a Cronbach's coefficient of 0.75. The measure, referred to as the Ask, Understand, Remember Assesment, (AURA) was moderately correlated with the total score from an existing chronic disease management self-efficacy scale (r=0.31) and disease knowledge (beta coefficient=0.2, 95% Confidence Interval 0.04-0.3, p=.03). Patients with low health literacy had lower scores on the AURA than those with marginal or adequate health literacy (p.05). The AURA demonstrated high internal consistency and was correlated with both hypertension knowledge and a chronic disease self-efficacy scale. The AURA is brief, valid, has low reading demands, and is an appropriate tool for use among patients with chronic illness. It may also be useful in identifying and assisting patients who are at risk for errors or non-adherence with self-care behaviors.