The General Practice Assessment Questionnaire (GPAQ) - Development and psychometric characteristics
The General Practice Assessment Questionnaire (GPAQ) - Development and psychometric characteristics
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DOI：
10.1186/1471-2296-9-13
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发表时间：
2008-02-20
影响因子：
2.9
通讯作者：
Roland, Martin
中科院分区：
文献类型：
--
作者：
Mead, Nicola;Bower, Peter;Roland, Martin
背景：持续改进初级保健的质量是一个国际优先事项。在联合王国，改善护理质量的主要举措是2004年全科医生合同的质量和成果框架(QOF)。虽然质素保证框架的主要焦点是临床护理，但大家都知道，全面的质素评估亦需要有效和可靠地衡量病人的观点，因此，在普通科医生合约中加入经济诱因，以调查病人的意见。在QOF中指定使用的一份问卷是一般实践评估问卷(GPAQ)。本文描述了GPAQ的发展(有咨询后版本和邮寄版本)，并对问卷的心理测量学特性进行了初步检验。方法：基于2005-6合同年在英国进行的常规GPAQ调查的大量数据集(n=190,038对GPAQ咨询版本的回复和20,309对邮政版本的回复)，描述量表的编制和对心理测量学特征(内部信度、因素结构)的初步分析。结果：受访者倾向于报告总体上良好的评价。在全科医生沟通量表上，回答的偏差尤其严重，尽管不比英国目前使用的其他可获得数据的问卷更不公平。因素分析确定了两个因素，它们清楚地与初级保健质量中的核心概念(获取和人际关怀)有关，这两个因素在两个版本的GPAQ中都是共同的。其他因素与咨询后版本的“使命性”和邮政版本的“护理”有关。结论：GPAQ量表具有较好的内部信度，各条目具有可解释的因素结构。讨论了与GPAQ响应分布有关的问题。还概述了GPAQ项目内容可能的进一步发展。
Background: Continual quality improvement in primary care is an international priority. In the United Kingdom, the major initiative for improving quality of care is the Quality and Outcomes Framework (QoF) of the 2004 GP contract. Although the primary focus of the QoF is on clinical care, it is acknowledged that a comprehensive assessment of quality also requires valid and reliable measurement of the patient perspective, so financial incentives are included in the contract for general practices to survey patients' views. One questionnaire specified for use in the QoF is the General Practice Assessment Questionnaire (GPAQ). This paper describes the development of the GPAQ (with post-consultation and postal versions) and presents a preliminary examination of the psychometric properties of the questionnaire.Methods: Description of scale development and preliminary analysis of psychometric characteristics (internal reliability, factor structure), based on a large dataset of routinely collected GPAQ surveys (n = 190,038 responses to the consultation version of GPAQ and 20,309 responses to the postal version) from practices in the United Kingdom during the 2005-6 contract year.Results: Respondents tend to report generally favourable ratings. Responses were particularly skewed on the GP communication scale, though no more so than for other questionnaires in current use in the UK for which data were available. Factor analysis identified 2 factors that clearly relate to core concepts in primary care quality ('access' and 'interpersonal care') that were common to both version of the GPAQ. The other factors related to 'enablement' in the post-consultation version and 'nursing care' in the postal version.Conclusion: This preliminary evaluation indicates that the scales of the GPAQ are internally reliable and that the items demonstrate an interpretable factor structure. Issues concerning the distributions of GPAQ responses are discussed. Potential further developments of the item content for the GPAQ are also outlined.