Medical Staff Organization in Nursing Homes: Scale Development and Validation
Medical Staff Organization in Nursing Homes: Scale Development and Validation
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DOI：
10.1016/j.jamda.2009.04.002
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发表时间：
2009-09-01
影响因子：
7.6
通讯作者：
Lima, Julie
中科院分区：
文献类型：
--
作者：
Katz, Paul R.;Karuza, Jurgis;Lima, Julie
目的：构建一个多维度的自我报告量表来测量护理之家（NH）的医务人员组织（NHMSO）维度，然后使用全国医疗主任调查来提供其心理测量学特性的数据。设计和方法：仪器开发过程包括护理之家医生劳动力会议的会议记录和焦点小组，然后是认知访谈，这一研究的高潮是对美国医学主任协会（AMDA）附属医学主任的随机抽样调查。对与独立非儿科护理院的在线调查认证和报告（OSCAR）数据相匹配的调查进行分析。共有202份调查可供分析，并组成了最后的samples.Results：尺寸确定，测量的程度，医务人员组织在疗养院，包括工作人员的组成，任命过程中，承诺（physiciancohesion;领导层的营业额/能力），部门化（医生的监督，自主权和跨学科的参与），文件，和非正式的动态。开发的项目来衡量每个维度是可靠的（克朗巴赫的α范围从0.81到0.65）。量表维度之间的相互关系提供了初步证据的结构效度的scale.Implications：这份报告，有史以来第一次，定义和验证NH医务人员组织的维度，在确定医生的做法和护理质量之间的关系，在NH提供关键的第一步。（《美国医学博士杂志》，2009年;10：498-504）
Purpose: To construct a multidimensional self-report scale to measure nursing home (NH) medical staff organization (NHMSO) dimensions and then pilot the scale using a national survey of medical directors to provide data on its psychometric properties.Design and Methods: Instrument development process consisting of the proceedings from the Nursing Home Physician Workforce Conference and focus groups followed by cognitive interviews, which culminated in a survey of a random sample of American Medical Directors Association (AMDA) affiliated medical directors. Analyses were conducted on surveys matched to Online Survey Certification and Reporting (OSCAR) data from freestanding nonpediatric nursing homes. A total of 202 surveys were available for analysis and comprised the final sample.Results: Dimensions were identified that measured the extent of medical staff organization in nursing homes and included staff composition, appointment process, commitment (physiciancohesion; leadership turnover/capability), departmentalization (physician supervision, autonomy and interdisciplinary involvement), documentation, and informal dynamics. The items developed to measure each dimension were reliable (Cronbach's alpha ranged from 0.81 to 0.65). Intercorrelations among the scale dimensions provided preliminary evidence of the construct validity of the scale.Implications: This report, for the first time ever, defines and validates NH medical staff organization dimensions, a critical first step in determining the relationship between physician practice and the quality of care delivered in the NH. (J Am Med Dir Assoc 2009;10: 498-504)