Development and evaluation of the measurement properties of a generic questionnaire measuring patient perceptions of person-centred care.
Development and evaluation of the measurement properties of a generic questionnaire measuring patient perceptions of person-centred care.
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DOI：
10.1186/s12913-020-05770-w
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发表时间：
2020-10-20
影响因子：
2.8
通讯作者：
Tistad M
中科院分区：
文献类型：
--
作者：
Fridberg H;Wallin L;Wallengren C;Kottorp A;Forsman H;Tistad M
实施以人为本的护理（PCC）是一项具有挑战性的任务。因此，人们呼吁建立一种强大的通用仪器来测量和评估跨环境和患者群体的 PCC。本研究旨在开发一份通用问卷来衡量患者对 PCC 的看法。进一步的目标是使用需要 Rasch 和定性内容分析的混合方法来评估其内容和测量属性。该研究分三个迭代阶段进行。第一阶段包括六位关键知情人，以获得对该概念的广泛了解。第二阶段需要进行德尔菲研究，涉及两轮，八位专家对相关性、可读性、全面性进行了评级，并提出了修改建议。使用项目内容有效性指数结合定性评论对数据进行分析，以改进调查问卷。第三阶段使用混合方法设计进行。定量数据是从瑞典医疗保健地区的六个住院和门诊护理单位中招募的回答问卷的患者（n = 553）中收集的。使用 Rasch 测量模型分析数据。定性数据基于受访者的自由文本评论、认知访谈（n = 10）和现场笔记，然后通过演绎内容分析进行分析。根据第一阶段关键知情人提供的信息制定并实施了调查问卷，然后在第二阶段由专家验证其内容。在第三阶段，Rasch 分析揭示了目标定位、阈值和两个不合适项目的问题。这些问题得到了定性分析数据的证实，同时也揭示了项目措辞和解释的一些问题。当阈值得到解决并删除两个项目后，调查问卷满足 Rasch 模型的假设。专家们对问卷内容给予了高度评价，修订后满足了Rasch模型假设的测量要求。这些关于目标的问题仍然需要在未来的研究中解决。同时，我们认为调查问卷的质量足以用于基准 PCC。
Implementation of person-centred care (PCC) is a challenging undertaking. Thus, a call has been issued for a robust and generic instrument to measure and enable evaluation of PCC across settings and patient groups. This study aimed to develop a generic questionnaire measuring patients’ perceptions of PCC. Further aims were to evaluate its content and measurement properties using a mixed-methods approach entailing Rasch and qualitative content analyses. The study was conducted in three iterative phases. Phase one included six key informants to gain a broad view of the concept. Phase two entailed a Delphi study involving two rounds with eight experts who generated ratings on relevance, readability, comprehensiveness and suggestions for revision. Data were analysed using the Item Content Validity Index in conjunction with qualitative comments to improve the questionnaire. Phase three was performed using a mixed-methods design. Quantitative data were collected from patients (n = 553) responding to the questionnaire who were recruited from six in- and outpatient care units in a health care region in Sweden. Data was analysed using the Rasch measurement model. Qualitative data were based on the respondents’ free-text comments, cognitive interviews (n = 10) and field notes, and then analysed with deductive content analysis. A questionnaire was developed and operationalised based on the information given by key informants in phase one and then validated for its content by experts in phase two. In phase three Rasch analyses revealed problems with targeting, thresholds and two misfitting items. These problems were corroborated by data from the qualitative analyses, which also revealed some issues of wording and interpretation of items. When thresholds were resolved and two items removed, the questionnaire met the assumptions of the Rasch model. Experts gave the questionnaire content high ratings and it met measurement requirements assumed by the Rasch model after revisions. Those problems on targeting that remain need to be addressed in future studies. Meanwhile, we regard the questionnaire as of sufficient quality to be useful in benchmarking PCC.
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作者：
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通讯作者：
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