The accident and emergency department questionnaire: a measure for patients' experiences in the accident and emergency department
The accident and emergency department questionnaire: a measure for patients' experiences in the accident and emergency department
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DOI：
10.1136/bmjqs-2012-001072
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发表时间：
2013-02-01
影响因子：
5.4
通讯作者：
van Stel, Henk F.
中科院分区：
文献类型：
--
作者：
Bos, Nanne;Sizmur, Steve;van Stel, Henk F.
国家卫生服务全国病人调查计划系统地收集病人关于他们最近接受的护理的经验。优先考虑事故和紧急（A&E）部门的质量改进活动要求调查结果有意义和可靠。我们的目的是确定哪种方法获得的A&E部问卷的总结分数最佳结合良好的解释性与强大的psychometric characteristics.Methods A&E部的问卷数据进行了分析，从151家医院的信任，涵盖49 646例患者。分组和总结问卷项目的三种方法进行了比较：主成分分析（PCA）;卫生部的尺寸;根据病人的旅程通过A&E部门的部分。用Cronbach’s a系数确定概括性评分的患者水平信度结果主成分分析在6个清晰可解释的成分上提供了最好的得分信度：等候时间、医生和护士。您的护理和治疗;卫生;出院前的信息;整体。这三种方法的概念区分能力相当，ICC在0.010和0.061之间。A&E样本量足以获得良好的可靠性A& E水平的平均scores.Conclusions的A&E部门问卷是一个有效的和可靠的问卷，以评估病人的经验与A&E。六个综合评分的区分力提供了A& E之间医疗保健性能的可靠比较，以提高以患者为中心的护理质量。
Background The National Health Service National Patient Survey Programme systematically gathers patients' experiences about the care they have recently received. Prioritising quality improvement activities in the accident and emergency (A&E) department requires that survey outcomes are meaningful and reliable. We aimed to determine which method of obtaining summary scores for the A&E department questionnaire optimally combined good interpretability with robust psychometric characteristics.Methods A&E department questionnaire data from 151 hospital trusts were analysed, covering 49 646 patients. Three methods of grouping and summarising items of the questionnaire were compared: principal components analysis (PCA); Department of Health dimensions; sections according to the patient's journey through the A&E department. The patient-level reliability of summary scores was determined by Cronbach's a coefficients (threshold: alpha>0.70), construct validity by Pearson's correlation coefficients, and the discriminative capacity by intra-class correlation coefficients (ICCs) and reliability of A&E-level mean scores.Results The PCA provided the best score reliability on six clear and interpretable composites: waiting time; doctors and nurses; your care and treatment; hygiene; information before discharge; overall. The discriminative power of the concepts was comparable for the three methods, with ICCs between 0.010 and 0.061. A&E sample sizes were adequate to obtain good to excellent reliability of A& E-level mean scores.Conclusions The A&E department questionnaire is a valid and reliable questionnaire to assess patients' experiences with the A&E. The discriminative power of six summary scores offers a reliable comparison of healthcare performance between A&Es to increase patient centredness and quality of care.