MEASURING INTERPERSONAL PROCESSES IN DIVERSE PATIENTS

描述：(摘自摘要)。有确凿的证据表明， 社会经济地位较低者或少数群体的健康 而不是他们的同行。很少有人注意到……的作用 医疗护理的质量，尽管众所周知，技术护理在 一些种族/民族群体。一个新出现的关于这些健康和 技术性护理差异是指人际护理过程中的差异 发生在病人和临床医生之间。在前期工作中，这个团队 开发并经验性测试了多维概念框架 人际关系的过程，融合了种族和 不同的社会经济群体。该框架普遍得到了一项 测量工具测量每一个概念，但需要做更多的工作 确保措施的可比性。该项目旨在最终确定框架。 和对人际关系过程的自我报告调查在概念上和 心理测量学适用于非裔美国人、拉丁裔和白人患者。 该工具的主要建议是使人际关系的检查成为可能 将流程作为解释卫生和技术护理的一种机制 差距。受试者是来自大型医院的18岁及以上患者 北加州的多专业小组实践背景，为种族服务， 不同种族、不同社会经济的患者。 这项横断面研究的具体目的是： 1.完善人际关系流程框架和基于工具的流程 关于新的定性研究(焦点小组、认知测试)和 来自3个种族/民族的第一代研究的数据， 和 2.对3组患者进行现场测试。 (n=每组1,200,400)，并评估心理测量特性 和假设的措施的有效性使用结构 方程建模，以确保最终的测量具有类似的 三组间的测量特性和效度。 由此产生的工具可以用来检查人际关系过程 与技术过程和临床结果有关。干预措施 从这样的研究中产生的可能有助于提高护理质量 对于不同的群体。

DESCRIPTION: (from the abstract). There is substantial evidence of poorer health for persons with lower socioeconomic status or from minority groups than for their counterparts. Little attention has been paid to the role of the quality of medical care, although technical care is known to be poorer for some racial/ethnic groups. One emerging hypothesis for these health and technical care disparities is differences in interpersonal processes of care that occur between patients and clinicians. In preliminary work, this team developed and empirically tested a multidimensional conceptual framework of interpersonal processes that incorporated views of ethnically and socioeconomically diverse groups. The framework was generally confirmed by a survey instrument measuring each of the concepts, but more work is needed to assure comparability of measures. This project aims to finalize the framework and self-report survey of interpersonal processes to be conceptually and psychometrically adequate for African American, Latino, and white patients. The main propose of the instrument is to enable examination of interpersonal processes as a mechanism by which to explain health and technical care disparities. Subjects are patients aged 18 and older from a large multispecialty group practice setting in Northern California serving racially, ethnically, and socioeconomically diverse patients. The specific aims of this cross-sectional study are to: 1. refine the interpersonal processes framework and instrument based on new qualitative studies (focus groups, cognitive testing) and data from the 1st generation study in the 3 racial/ethnic groups, and 2. field test the refined instrument in patients from 3 groups (N=1,200, 400 per group) and evaluate the psychometric properties and validity of the hypothesized measures using structural equation modeling to assure that the final measures have similar measurement properties and validity across the 3 groups. The resulting instrument can be used to examine how interpersonal processes are related to technical processes and clinical outcomes. Interventions arising from such studies could contribute to quality improvements in caring for diverse groups.