Development and Reliability of a Measure of Clinician Competence in Providing Illness Management and Recovery
Development and Reliability of a Measure of Clinician Competence in Providing Illness Management and Recovery
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DOI：
10.1176/appi.ps.201100144
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发表时间：
2012-08-01
影响因子：
3.8
通讯作者：
Salyers, Michelle P.
中科院分区：
文献类型：
--
作者：
McGuire, Alan B.;Stull, Laura G.;Salyers, Michelle P.
目的：疾病管理与康复（IMR）是一项针对严重精神疾病患者的循证、手动的疾病自我管理项目。本研究旨在发展一种衡量IMR临床医师能力的方法，并检验其信度和效度。方法：两组主题专家各自独立创建了一个临床水平的IMR能力量表，该量表基于IMR忠实度量表和两个未发表的用于评估提供者能力的工具。这两个版本被合并，调查人员使用最初的版本来独立评估IMR会话的录音。对评分进行比较和讨论，解决差异，并通过14次迭代对量表进行修订。由此产生的IMR治疗完整性量表（IT-IS）包括13个必需项目和3个可选项目，仅在尝试特定技能时进行评分。然后，四个独立的评分者使用IT-IS对60个IMR会话和20个对照组会话的磁带进行评分。结果：IT-IS具有良好的互信度（0.92）。因子分析支持单因素模型，显示出良好的内部一致性。量表成功区分了IMR组和对照组。个别项目的信度和效度差异很大。结论：IT-IS是临床医生提供IMR能力的一个有希望的衡量标准。该量表可用于研究和质量保证，并作为监督反馈工具。未来的研究需要检验项目水平的变化，IT-IS的预测效度，与其他更结构化的干预相比的判别效度，以及非组IMR量表的信度和效度。（精神病学服务63:772-778,2012;doi: 10.1176/app .ps.201100144）
Objective: Illness management and recovery (IMR) is an evidence-based, manualized illness self-management program for people with severe mental illness. This study sought to develop a measure of IMR clinician competence and test its reliability and validity. Methods: Two groups of subject matter experts each independently created a clinician-level IMR competence scale based on the IMR Fidelity Scale and on two unpublished instruments used to evaluate provider competence. The two versions were merged, and investigators used the initial version to independently rate recordings of IMR sessions. Ratings were compared and discussed, discrepancies were resolved, and the scale was revised through 14 iterations. The resulting IMR Treatment Integrity Scale (IT-IS) includes 13 required items and three optional items rated only when the particular skill is attempted. Four independent raters then used the IT-IS to score tapes of 60 IMR sessions and 20 control group sessions. Results: The IT-IS showed excellent interrater reliability (.92). A factor analysis supported a one-factor model that showed good internal consistency. The scale successfully differentiated between IMR and control groups. Reliability and validity of individual items varied widely. Conclusions: The IT-IS is a promising measure of clinician competence in providing IMR. The scale could be used for research and quality assurance and as a supervisory feedback tool. Future research is needed to examine item-level changes, predictive validity of the IT-IS, discriminant validity compared with other more structured interventions, and the reliability and validity of the scale for nongroup IMR. (Psychiatric Services 63:772-778, 2012; doi: 10.1176/appi.ps.201100144)