Development and validation of an instrument to measure collaborative goal setting in the care of patients with diabetes.
Development and validation of an instrument to measure collaborative goal setting in the care of patients with diabetes.
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DOI：
10.1136/bmjdrc-2016-000269
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发表时间：
2017
影响因子：
4.1
通讯作者：
Lafata JE
中科院分区：
文献类型：
--
作者：
Morris HL;Dumenci L;Lafata JE
尽管已知的好处，病人认为合作的目标设定，我们有一个有限的能力，在实践中监测这一过程。我们开发了合作目标设定的患者测量（PM-CGS），从患者的角度来评估合作目标设定的使用。随机抽取400例年龄在40岁或以上的患者，在2012年8月至2013年8月期间接受弗吉尼亚联邦大学卫生系统的糖尿病护理，邮寄了一份调查问卷，其中包含潜在的PM-CGS项目（n=44）以及患者人口统计学指标、自我管理能力、对医生的信任和自我管理行为。 结构效度采用影响因素分析。外部效度通过结构方程模型（SEM）进行评估，该模型测试了PM-CGS与自我管理行为的关联。直接和两个介导（通过信任和自我效能）的途径进行了测试。共有259名患者对调查做出回应（回应率为64%），其中192名符合入选资格。因素分析结果支持了一个37个项目的测量病人感知的CGS跨越五个领域：倾听和学习，分享想法，关怀关系，可测量的目标和目标实现支持（χ=4366.13，p<0.001; RMSEA=0.08）。结构方程模型的结果支持PM-CGS的外部效度。CGS与自我管理之间的关系部分通过知觉胜任力中介（p<0.05）。PM-CGS与自我管理之间的直接效应显著（P<0.001）。37项PM-CGS可以有效地测量CGS。使用PM-CGS可以帮助说明目标设定讨论中的可操作缺陷。
Despite known benefits of patient-perceived collaborative goal setting, we have a limited ability to monitor this process in practice. We developed the Patient Measure of Collaborative Goal Setting (PM-CGS) to evaluate the use of collaborative goal setting from the patient's perspective. A random sample of 400 patients aged 40 years or older, receiving diabetes care from the Virginia Commonwealth University Health System between 8/2012 and 8/2013, were mailed a survey containing potential PM-CGS items (n=44) as well as measures of patient demographics, perceived self-management competence, trust in their physician, and self-management behaviors. Confirmatory factor analysis was used to evaluate construct validity. External validity was evaluated via a structural equation model (SEM) that tested the association of the PM-CGS with self-management behaviors. The direct and two mediated (via trust and self-efficacy) pathways were tested. A total of 259 patients responded to the survey (64% response rate), of which 192 were eligible for inclusion. Results from the factor analysis supported a 37-item measure of patient-perceived CGS spanning five domains: listen and learn; share ideas; caring relationship; measurable objective; and goal achievement support (χ=4366.13, p<0.001; RMSEA=0.08). Results from the SEM supported the external validity of the PM-CGS. The relationship between CGS and self-management was partially mediated by perceived competence (p<0.05). The direct effect between the PM-CGS and self-management was significant (p<0.001). CGS can be validly measured by the 37-item PM-CGS. Use of the PM-CGS can help illustrate actionable deficits in goal-setting discussions.