癌症护理环境中以患者为中心的沟通措施的心理计量学评估和设计。
Psychometric evaluation and design of patient-centered communication measures for cancer care settings.
机构信息
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 E. Weaver Street, Suite 220, Carrboro, NC, 27510, USA; Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1105-B McGavran-Greenberg Hall, CB#7411, Chapel Hill, NC, 27599-7411, USA.
Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, CB #3270, Davie Hall, Chapel Hill, NC 27599-3270, USA.
出版信息
Patient Educ Couns. 2017 Jul;100(7):1322-1328. doi: 10.1016/j.pec.2017.02.011. Epub 2017 Feb 10.
OBJECTIVE
To evaluate the psychometric properties of questions that assess patient perceptions of patient-provider communication and design measures of patient-centered communication (PCC).
METHODS
Participants (adults with colon or rectal cancer living in North Carolina) completed a survey at 2 to 3 months post-diagnosis. The survey included 87 questions in six PCC Functions: Exchanging Information, Fostering Health Relationships, Making Decisions, Responding to Emotions, Enabling Patient Self-Management, and Managing Uncertainty. For each Function we conducted factor analyses, item response theory modeling, and tests for differential item functioning, and assessed reliability and construct validity.
RESULTS
Participants included 501 respondents; 46% had a high school education or less. Reliability within each Function ranged from 0.90 to 0.96. The PCC-Ca-36 (36-question survey; reliability=0.94) and PCC-Ca-6 (6-question survey; reliability=0.92) measures differentiated between individuals with poor and good health (i.e., known-groups validity) and were highly correlated with the HINTS communication scale (i.e., convergent validity).
CONCLUSION
This study provides theory-grounded PCC measures found to be reliable and valid in colorectal cancer patients in North Carolina. Future work should evaluate measure validity over time and in other cancer populations.
PRACTICE IMPLICATIONS
The PCC-Ca-36 and PCC-Ca-6 measures may be used for surveillance, intervention research, and quality improvement initiatives.
目的
评估评估患者对医患沟通的看法并设计以患者为中心的沟通（PCC）衡量标准的问题的心理计量学特性。
方法
参与者（居住在北卡罗来纳州的结肠癌或直肠癌成年人）在诊断后 2 至 3 个月完成了一项调查。该调查包括六个 PCC 功能中的 87 个问题：信息交流、促进健康关系、决策、回应情绪、促进患者自我管理和管理不确定性。对于每个功能，我们进行了因素分析、项目反应理论建模以及差异项目功能测试，并评估了可靠性和构念效度。
结果
参与者包括 501 名受访者；46%的人受过高中或以下教育。每个功能内的可靠性范围为 0.90 至 0.96。PCC-Ca-36（36 题调查；可靠性=0.94）和 PCC-Ca-6（6 题调查；可靠性=0.92）测量方法可区分健康状况不佳和良好的个体（即，已知群体有效性），并且与 HINTS 沟通量表高度相关（即，收敛有效性）。
结论
本研究提供了在北卡罗来纳州结肠癌患者中发现可靠有效的基于理论的 PCC 衡量标准。未来的工作应评估随时间推移和在其他癌症人群中的测量有效性。
实践意义
PCC-Ca-36 和 PCC-Ca-6 测量方法可用于监测、干预研究和质量改进计划。
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