Measuring nonspecific factors in treatment: item banks that assess the healthcare experience and attitudes from the patient's perspective.
Measuring nonspecific factors in treatment: item banks that assess the healthcare experience and attitudes from the patient's perspective.
复制标题
DOI：
10.1007/s11136-015-1178-1
复制
发表时间：
2016-07
期刊：
影响因子：
--
通讯作者：
Pilkonis PA
中科院分区：
文献类型：
--
作者：
Greco CM;Yu L;Johnston KL;Dodds NE;Morone NE;Glick RM;Schneider MJ;Klem ML;McFarland CE;Lawrence S;Colditz J;Maihoefer CC;Jonas WB;Ryan ND;Pilkonis PA
伴随医疗保健治疗的非特异性因素，如患者的态度和期望，是护理经验的重要组成部分，并可能影响结果。然而，没有精确的，简洁的，和通用的工具来衡量这些因素存在。我们报告了新项目库的开发和校准，名为“治疗遭遇和态度列表”（HEAL），该列表评估了广泛的治疗和条件中的非特异性因素。使用了患者报告结局测量信息系统（PROMIS®）的工具开发方法。患者焦点小组和临床医生访谈为我们的HEAL概念模型提供了信息。8个数据库的文献检索产生了500多个仪器，并产生了数千个项目的初始项目池。经过定性项目分析，包括认知访谈，296个项目被纳入现场测试。校准样本包括1657名受访者，1400人通过互联网面板获得，257人来自传统和中西医结合诊所。探索性和验证性因素分析后，使用项目反应理论（IRT）校准的HEAL题库。最终的HEAL项目库是患者-提供者连接（57项），医疗保健环境（25项），治疗期望（27项），积极展望（27项）和灵性（26项）。还从每个试题库中编制了简短的表格。还创建了一个6项简短表格，即对补充和替代医学的态度。HEAL项目库提供了每个结构的广泛范围内的大量信息。HEAL项目库显示了预测和并发有效性的初步证据，表明它们适合测量治疗中的非特异性因素。
Nonspecific factors that accompany healthcare treatments, such as patients’ attitudes and expectations, are important parts of the experience of care and can influence outcomes. However, no precise, concise, and generalizable instruments to measure these factors exist. We report on the development and calibration of new item banks, titled the Healing Encounters and Attitudes Lists (HEAL), that assess nonspecific factors across a broad range of treatments and conditions. The instrument development methodology of the Patient-Reported Outcomes Measurement Information System (PROMIS®) was used. Patient focus groups and clinician interviews informed our HEAL conceptual model. Literature searches of 8 databases yielded over 500 instruments and resulted in an initial item pool of several thousand items. After qualitative item analysis, including cognitive interviewing, 296 items were included in field testing. The calibration sample included 1657 respondents, 1400 obtained through an internet panel and 257 from conventional and integrative medicine clinics. Following exploratory and confirmatory factor analyses, the HEAL item banks were calibrated using item response theory (IRT). The final HEAL item banks were Patient-Provider Connection (57 items), Healthcare Environment (25 items), Treatment Expectancy (27 items), Positive Outlook (27 items), and Spirituality (26 items). Short forms were also developed from each item bank. A 6-item short form, Attitudes toward Complementary and Alternative Medicine (CAM) was also created. HEAL item banks provided substantial information across a broad range of each construct. HEAL item banks showed initial evidence of predictive and concurrent validity, suggesting they are suitable for measuring nonspecific factors in treatment.