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首页> 外文期刊>BMC Health Services Research >Patients’ assessment of chronic illness care: a validation study among patients with type 2 diabetes in Finland
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Patients’ assessment of chronic illness care: a validation study among patients with type 2 diabetes in Finland

机译：患者对慢性病护理的评估：芬兰2型糖尿病患者的一项验证研究

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To meet the challenges of the rising prevalence of chronic diseases, such as type 2 diabetes, new approaches to healthcare delivery have been initiated; among these the influential Chronic Care Model (CCM). Valid instruments are needed to evaluate the public health impact of these frameworks in different countries. The Patient Assessment of Chronic Illness Care (PACIC) is a 20-item quality of care measure that, from the perspective of the patient, measures the extent to which care is congruent with the CCM. The aim of this study was to evaluate the psychometric properties of the Finnish translation of the PACIC questionnaire, in terms of validity and reliability, in a large register-based sample of patients with type 2 diabetes. The PACIC items were translated into Finnish in a standardized forward-backward procedure, followed by a cross-sectional survey among patients with type 2 diabetes (response rate 56%; n?=?2866). We assessed the Finnish version of the PACIC scale for the following psychometric properties: content validity, internal consistency reliability, convergent and construct validity. We also present descriptive data on total scale as well as predetermined subscale levels. The item-response on the PACIC scale was high with only small numbers of missing data (0.5–1.1%). Ceiling effects were low (0.3–5.3%) whereas floor effects were over 20% for two of the predetermined subscales (problem solving and follow-up/coordination). The total PACIC scale showed a reasonable distribution and excellent internal consistency (alpha 0.94) while the internal consistency of the subscales were at least acceptable (0.74–0.86). The principal component analysis identified a two- or three-factor solution instead of the proposed five-dimensional. In other respects, the PACIC scale showed the hypothesized relationships with quality of care and outcome measures, thus demonstrating convergent and construct validity. A Finnish version of the PACIC scale is now validated in the primary care setting among patients with type 2 diabetes. The findings suggest comparable psychometric properties of the Finnish scale as of the original English instrument and earlier translations, and reasonable levels of validity and reliability.
机译：为了应对诸如2型糖尿病之类的慢性病流行率上升的挑战，已经开始采用新的医疗保健方法。其中有影响力的慢性护理模型（CCM）。需要有效的手段来评估这些框架在不同国家对公共卫生的影响。慢性病患者护理评估（PACIC）是一项20个项目的护理质量衡量标准，从患者的角度出发，它衡量了CCM与护理保持一致的程度。这项研究的目的是在大量基于登记册的2型糖尿病患者样本中，从有效性和可靠性方面评估PACIC问卷芬兰语翻译的心理计量学特性。将PACIC项目以标准化的前后流程翻译成芬兰语，然后对2型糖尿病患者进行横断面调查（答复率为56％; n = 2866）。我们评估了以下版本的PACIC量表的芬兰语版本的心理计量特性：内容效度，内部一致性信度，收敛性和构造效度。我们还介绍了总体规模以及预定的子规模水平上的描述性数据。 PACIC量表上的项目响应很高，仅丢失少量数据（0.5–1.1％）。对于两个预定的子量表（问题解决和跟进/协调），天花板效应较低（0.3-5.3％），而地板效应则超过20％。总体PACIC量表显示出合理的分布和出色的内部一致性（α0.94），而子量表的内部一致性至少可以接受（0.74-0.86）。主成分分析确定了两因素或三因素解决方案，而不是建议的五维解决方案。在其他方面，PACIC量表显示了与护理质量和结果指标之间的假设关系，从而证明了收敛性和构造效度。芬兰的PACIC量表现已在2型糖尿病患者的初级保健机构中得到验证。研究结果表明，与原始英语工具和较早的翻译版本相比，芬兰语的心理计量学特性具有可比性，并且其有效性和可靠性也处于合理水平。

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