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的(简短、廉价、用户友好、具有标准化项目反应) 通过输入两个重要的“声音”：病人及其非正式照顾者，获取和监测到初级保健诊所就诊的老年病人的多种疾病症状严重程度的有效工具。预期结果是一个利益相关者增强的有效、多维度和临床有用的工具，它解决了转化性和以患者为中心的结果研究中的一个主要差距。这项研究的结果将使我们离将研究与临床实践相结合的长期目标更近一步。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和专家小组的意见)，开发临床实用的健康老龄化护理(HAC)监测工具版本1.0，用于监测初级保健中老年(e 65岁)患者的照顾者和患者症状报告。具体目标2：使用混合方法，实地测试和修订健康老龄化护理(HAC)监测1.0版，使用对所有关键利益攸关方(患者、照顾者、提供者)的认知访谈和定量调查 在小样本(患者和他们的非正式照顾者)中评估可用性和可行性。具体目标3：对健康老龄化护理(HAC)监测仪的患者报告和照顾者报告的最终版本(2.0版)进行全面的心理测量评估，以评估其内部一致性和重测可靠性、患者和照顾者之间的“一致性”、患者保健利用的结构效度、预测效度和敏感度，以在更大的二元样本(患者及其非正式照顾者)中从基线改变到3个月评估。这项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来开发工具；通过电话调查的小样本现场测试对40名患者及其40名照顾者的可用性和可行性描述性统计；以及使用从200名患者及其200名照顾者的大样本电话调查数据进行的可靠性和有效性的心理测量学评估。

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.