Develop and Validate Tool to Monitor Patient Centered Outcomes Through Caregivers

描述（由申请人提供）：拟议研究的目标是开发和验证临床实用（简短，廉价，用户友好，具有标准化的项目响应） 格式）和研究有效的工具，捕捉和监测的多种疾病的症状严重程度的老年病人谁参加初级保健诊所通过两个重要的“声音”的输入：病人和他们的非正式照顾者。预期的结果是一个有效的，多维度的，临床上有用的工具，解决了翻译和以患者为中心的结果研究的主要差距。这项研究的结果将使我们更接近我们整合研究和临床实践的长期目标。具体目标如下。具体目标1：使用混合方法（利益相关者焦点小组，现有数据的心理测量分析，并从专家小组的输入），开发版本1.0的临床实用的健康老龄化护理（HAC）监测工具，用于监测护理人员和患者报告的症状老年（年龄65岁）患者在初级保健。具体目标二：使用混合方法，现场测试和修订健康老龄化护理（HAC）监测器1.0版，使用所有关键利益相关者（患者，护理人员，提供者）的认知访谈和定量调查， 在一个小样本的二元组（患者及其非正式护理人员）中评估可用性和可行性。具体目标3：对患者报告和非患者报告的最终版本进行全面的心理测量评估（2.0版）的健康老龄化护理（HAC）监测，以评估其内部一致性和重测信度，病人和照顾者之间的“一致性”，结构效度，预测效度的病人的医疗服务利用，和敏感性变化从基线到3个月的评估，在一个较大的样本的二分体（病人和他们的非正式照顾者）。研究的混合方法设计和分析将包括通过焦点小组、认知访谈、项目统计和专家小组判断的工具开发：40名患者及其40名护理人员的可用性和可行性描述性统计i电话调查的小样本现场测试;和心理测量学评估的信度和效度使用电话调查数据，从更大的样本200名患者和他们的200名照顾者。

DESCRIPTION (provided by applicant): The goal of the proposed research is to develop and validate a clinically practical (brief, inexpensive, user friendly, with standardized item response format) and research-valid tool for capturing and monitoring the multi-disease symptom severity of elderly patients who attend primary care clinics through the input of two important "voices": the patient and their informal caregiver. The expected outcome is a stakeholder-enhanced valid, multi-dimensional, and clinically useful tool which addresses a major gap in translational and patient-centered outcomes research. Findings from the study will bring us one step closer to our long term goal of integrating research and clinical practice. The specific aims are as follows. Specific Aim 1: Using mixed-methods (stakeholder focus groups, psychometric analyses of existing data, and input from an expert panel), develop Version 1.0 of the clinically practical Healthy Aging Care (HAC) Monitor tool for monitoring caregiver and patient reports of symptoms for older (age e 65) patients in primary care. Specific Aim 2: Using mixed-methods, field test and revise Version 1.0 of the Healthy Aging Care (HAC) Monitor using cognitive interviewing of all key stakeholders (patients, caregivers, providers) and a quantitative survey to assess usability and feasibility in a small sample of dyads (patients and their informal caregivers). Specific Aim 3: Conduct a full psychometric evaluation of the patient-reported and caregiver-reported final version (Version 2.0) of the Healthy Aging Care (HAC) Monitor to assess its internal consistency and test-retest reliability, "congruence" between patient and caregiver, construct validity, predictive validity of patients' health care utilization, and sensitvity to change from baseline to 3-month assessment in a larger sample of dyads (patients and their informal caregivers). The study's mixed methods design and analyses will include instrument development through focus groups, cognitive interviewing, item statistics, and expert panel judgment; usability and feasibility descriptive statistics of 40 patients and their 40 caregivers i a small-sample field testing of a telephone survey; and psychometric evaluation of reliability and validity using telephone survey data from a larger sample of 200 patients and their 200 caregivers.