Development of a Caregiver-Reported Experience Measure for Pediatric Hospital-to-Home Transitions
Development of a Caregiver-Reported Experience Measure for Pediatric Hospital-to-Home Transitions
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DOI：
10.1111/1475-6773.12864
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发表时间：
2018-08-01
影响因子：
3.4
通讯作者：
Howard, Waylon J.
中科院分区：
文献类型：
--
作者：
Desai, Arti D.;Jacob-Files, Elizabeth A.;Howard, Waylon J.
目的开发和测试一个儿童从医院到家庭过渡的经验测量。数据来源/研究设置主要数据收集于2014年7月至2015年5月期间，从儿童从三级儿童医院出院后2- 8周内的照顾者那里收集。研究设计/数据收集我们使用了一个步骤-制定衡量标准的明智方法，包括根据护理人员访谈起草从头调查项目（n=18），使用认知访谈预测试项目（n=18），并在独立样本的照顾者（n=500）中对修订后的项目进行试点测试。项目缩减统计和验证性因素分析（CFA）进行了测试样本的试点数据，以完善措施，然后CFA验证样本，以测试最终的措施modelfitt.Principal FindingsOf 46个初始调查项目，19个被删除后，预测试和19个被删除后，进行项目统计和CFA。这导致了两个领域的八项措施：过渡准备（四个项目）和过渡支持（四个项目）。调查项目评估出院指示的质量，获得所需的支持和资源，护理协调和后续护理。实际拟合指数显示了可接受的模型拟合：（2）=28.3（df=19）;近似均方根误差=0.04;比较拟合指数=0.99; Tucker-Lewis指数= 0.98。
ObjectiveTo develop and test a caregiver-reported experience measure for pediatric hospital-to-home transitions.Data Sources/Study SettingPrimary data were collected between 07/2014 and 05/2015 from caregivers within 2-8weeks of their child's discharge from a tertiary care children's hospital.Study Design/Data CollectionWe used a step-wise approach to developing the measure that included drafting de novo survey items based on caregiver interviews (n=18), pretesting items using cognitive interviews (n=18), and pilot testing revised items among an independent sample of caregivers (n=500). Item reduction statistics and confirmatory factor analysis (CFA) were performed on a test sample of the pilot data to refine the measure, followed by CFA on the validation sample to test the final measure model fit.Principal FindingsOf 46 initial survey items, 19 were removed after pretesting and 19 were removed after conducting item statistics and CFA. This resulted in an eight-item measure with two domains: transition preparation (four items) and transition support (four items). Survey items assess the quality of discharge instructions, access to needed support and resources, care coordination, and follow-up care. Practical fit indices demonstrated an acceptable model fit: (2)=28.3 (df=19); root-mean-square error of approximation=0.04; comparative fit index=0.99; and Tucker-Lewis index=0.98.ConclusionsAn eight-item caregiver-reported experience measure to evaluate hospital-to-home transition outcomes in pediatric populations demonstrated acceptable content validity and psychometric properties.