How do stakeholder groups vary in a Delphi technique about primary mental health care and what factors influence their ratings?
How do stakeholder groups vary in a Delphi technique about primary mental health care and what factors influence their ratings?
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DOI：
10.1136/qshc.2003.007815
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发表时间：
2004-12-01
影响因子：
--
通讯作者：
Gask, L
中科院分区：
文献类型：
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作者：
Campbell, SM;Shield, T;Gask, L
背景资料：虽然心理健康是初级保健的核心部分，但很少有经过验证的质量措施，也很少有相关的国际发表的研究。共识小组方法是一个有用的手段，制定质量措施的证据是稀疏和/或意见是不同的。然而，很少有人知道的动态共识技术和影响因素的判断和评级的小组和个人panelists.Objectives：（1）描述的差异，小组评级的质量上的初级精神卫生保健服务的病人，照顾者，专业和管理小组内的德尔菲程序;设计：两轮邮政德尔菲技术和探索性半结构化访谈。结果：在334项指标中，87项（26%）被所有11个小组评为表面有效。小组内的评级几乎没有分歧，但小组之间的显着差异。全科医生小组评定的有效指标最少（n = 138，41%），护理人员最多（n = 304，91%）。小组成员的方式解释和概念化的指标和他们的精神卫生保健质量的定义影响了参与者的方式，使他们的ratings.Conclusions：利益相关者在初级精神卫生保健的护理质量有不同的看法，这些差异转化为他们如何率质量指标。探索性访谈表明，评级的影响，过去的经验，期望，护理质量的定义，和利益相关者之间的感知权力关系。
Background: While mental health is a core part of primary care, there are few validated quality measures and little relevant internationally published research. Consensus panel methods are a useful means of developing quality measures where evidence is sparse and/or opinions are diverse. However, little is known about the dynamics of consensus techniques and the factors that influence the judgements and ratings of panels and individual panellists.Objectives: (1) To describe differences in panel ratings on the quality of primary mental health care services by patient, carer, professional and managerial panels within a Delphi procedure; and (2) to explore why different panels and panellists rate quality indicators of primary mental health care differently.Design: Two round postal Delphi technique and exploratory semi-structured interviews.Participants: 115 panellists across 11 panels. Eleven panellists were subsequently interviewed.Results: 87 of 334 indicators (26%) were rated face valid by all 11 panels. There was little disagreement within panel ratings but significant differences between panels. The GP panel rated the least number of indicators valid (n = 138, 41%) and carers the most (n = 304, 91%). The way in which panellists interpreted and conceptualised the indicators and their definition of quality of mental health care affected the way in which participants made their ratings.Conclusions: Stakeholders in primary mental health care have diverse views of quality of care and these differences translate into how they rate quality indicators. Exploratory interviews suggest that ratings are influenced by past experience, expectations, definitions of quality of care, and perceived power relationships between stakeholders.