Can Naive Viewers Put Themselves in the Patients' Shoes? Reliability and Validity of the Analogue Patient Methodology
Can Naive Viewers Put Themselves in the Patients' Shoes? Reliability and Validity of the Analogue Patient Methodology
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DOI：
10.1097/mlr.0b013e31822945cc
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发表时间：
2013-03-01
期刊：
影响因子：
3
通讯作者：
Irish, Julie T.
中科院分区：
文献类型：
--
作者：
Blanch-Hartigan, Danielle;Hall, Judith A.;Irish, Julie T.
背景：模拟病人（ap）是未经训练的观众，在扮演病人角色的同时，被赋予观看和评价他们对医疗互动的印象的任务。当使用真实患者（RP）群体是不道德或不切实际时，这种方法通常用于评估患者的看法。目的：本研究检验AP方法的信度和效度及其最佳实施。研究设计：216名ap观看了46段RP与医生互动的录像，其中存在RP满意度评分，并对满意度进行了评分。评估AP满意度评分的互评者信度。AP和RP满意度评分相互比较，并与医生的观察者编码的以患者为中心相关。测量方法：在整个互动结束后，采用15项量表测量RP满意度。医生以病人为中心的行为采用四种习惯编码方案进行编码。AP满意度是在观察了整个互动后测量的，其中包括一个满意度问题，一个包含该单项的4项满意度量表，以及rp使用的原始15项满意度量表。结果：AP满意度评分可靠（4个AP的alpha=0.70）。AP满意度是RP满意度的重要预测因子（r = 0.29, P = 0.05），特别是当分析仅限于报告不完全满意的RP时（r = 0.65, P = 0.002）。AP满意度比RP满意度更能预测提供者在互动中以病人为中心的行为。结论：AP方法是一种有效和可靠的方法来收集关于提供者-患者互动的患者感知数据。结果为使用AP方法的研究人员提供了实用建议。
Background: Analogue patients (APs) are untrained viewers given the task of viewing and rating their impressions of a medical interaction while taking on the patient role. This methodology is often used to assess patient perceptions when using real patient (RP) populations is unethical or impractical. Objectives: This study examines the reliability and validity of the AP methodology and its optimal implementation.Research Design: Forty-six videotaped interactions of RP-physician interactions, where RP satisfaction scores existed, were viewed by 216 APs, who rated satisfaction. Interrater reliability for AP satisfaction scores was evaluated. AP and RP satisfaction scores were compared with each other and correlated with the physician's observer-coded patient-centeredness.Measures: RP satisfaction was measured with a 15-item scale after the whole interaction. Physicians' patient-centered behavior was coded with the Four Habits Coding Scheme. AP satisfaction was measured after viewing the entire interaction with a single satisfaction question, a 4-item satisfaction scale including that single item, and the original 15-item satisfaction scale used by the RPs.Results: AP satisfaction ratings were reliable (alpha=0.70 for 4 APs). AP satisfaction was a significant predictor of RP satisfaction (r = 0.29, P = 0.05), especially when the analysis was limited to the RPs who reported being less than perfectly satisfied (r = 0.65, P = 0.002). AP satisfaction was a better predictor than RP satisfaction of providers' patient-centered behaviors in the interaction. Conclusions: The AP methodology is a valid and reliable approach to gathering patient perception data about provider-patient interactions. Results suggest practical advice for researchers using the AP methodology.