背景:患者反馈是医疗保健提供者了解患者体验并有效提高护理质量并促进医疗保健系统中以患者为中心的护理的重要途径。这项研究旨在通过评估事故和紧急体验问卷(AEEQ)的心理测量特性来建议一种经过验证的工具,以测量中国成年人口中在事故和急诊科(AED)服务中的患者体验。
方法:针对2016年6月16-30日所有公立医院18岁或以上AED患者的出勤率,并使用AEEQ进行横断面电话调查。初步AEEQ由92个项目组成,包括53个核心评价项目和19个信息项目,其他20个项目涵盖了社会人口统计学,自我感知的健康状况,以及关于AED服务的免费开放式评论。对评价项目的心理测量特性进行了实用性评价,内容和结构有效性,内部一致性,和本研究中的重测信度。
结果:共纳入512例患者,缓解率为54%,平均年龄为53.2岁。探索性因素分析建议删除7个项目,由于弱因素负荷和高交叉负荷,然后将46个项目分为5个维度,护理和治疗(14项),环境和设施(16项),关于药物和危险信号的信息(5项),临床调查(3项),和总体印象(8项)来代表患者对AED服务的体验。内部一致性和重测信度较高,建议量表的Cronbachα系数和Spearman相关系数分别为0.845和0.838。
结论:AEEQ是评估AED服务的有效和可靠的工具,有助于建立参与平台,促进患者和一线医疗保健专业人员之间以患者为中心的护理,并提高未来的医疗保健质量。
BACKGROUND: Patient feedback is an important way for healthcare providers to understand patient experience and improve the quality of care effectively and facilitate patient-centered care in the healthcare system. This study aimed to suggest a validated instrument by evaluating the psychometric properties of the Accident and Emergency Experience Questionnaire (AEEQ) for measuring patient experience in the accident and emergency department (AED) service among the adult Chinese population.
METHODS: Attendances aged 18 or above from all public hospitals with AEDs during 16-30 June 2016 were targeted and a cross-sectional telephone survey was conducted using AEEQ. Preliminary AEEQ consisted of 92 items, including 53 core evaluative items and 19 informative items, and the other 20 items covered socio-demographics, self-perceived health status, and free open-ended comments on AED service. Psychometric properties of the evaluative items were evaluated for practicability, content and structure validity, internal consistency, and test-retest reliability in this study.
RESULTS: A total of 512 patients were recruited with a response rate of 54% and a mean age of 53.2 years old. The exploratory factor analysis suggested removing 7 items due to weak factor loadings and high cross-loading and then leaving 46 items grouped into 5 dimensions, which were care and treatment (14 items), environment and facilities (16 items), information on medication and danger signals (5 items), clinical investigation (3 items), and overall impression (8 items) to represent patient experience on AED service. The internal consistency and test-retest reliability were high with Cronbach\'s alpha coefficient and Spearman\'s correlation coefficient of the suggested scale of 0.845 and 0.838, respectively.
CONCLUSIONS: The AEEQ is a valid and reliable instrument to evaluate the AED service which helps to build the engagement platform for promoting patient-centered care between patients and frontline healthcare professionals and improving healthcare quality in the future.