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Patient Assessment of Chronic Illness Care (PACIC) in Type 2 Diabetes: A Longitudinal Study

机译：2型糖尿病患者慢性病护理（PACIC）的患者评估：一项纵向研究

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The Patient Assessment of Chronic Illness Care (PACIC) was designed to measure care congruent with several elements of the chronic care model (CCM), including self-management support and delivery system design. However, support for the a priori 5-subscale structure of the PACIC in previous research has been conflicting. Thus, we aim to investigate psychometric characteristics of the PACIC including the content and stability of its construct over time. A population-based prospective cohort study of patients with type 2 diabetes was conducted in Queensland, Australia, from 2008 (N = 3,761) to 2010 (N = 3,040). Participants completed annually the 20-item PACIC as well as measures of providers' adherence to guideline-recommended self-management support activities. We used exploratory factor analysis to determine its factor structure and examined internal consistency as well as agreement between the PACIC at baseline with repeated measurements at follow-up after 1 and 2 years. We also determined a criterion-related validity using multinomial logistic regression to explore PACIC's association with providers' self-management support. A one-factor structure was deemed optimal according to our findings. High internal consistency and moderate agreement within the scales over time were observed. Higher PACIC scores predicted better providers' self-management support. In conclusion, the PACIC is a reliable, valid, and reproducible instrument for assessment of diabetes care, and we recommend its promotion and use as a single scale rather than subscales as originally proposed.
机译：慢性病患者护理评估（PACIC）旨在衡量与慢性病护理模型（CCM）的多个要素相符的护理，包括自我管理支持和分娩系统设计。但是，在先前的研究中，对PACIC的先验5次分量表结构的支持一直存在冲突。因此，我们旨在研究PACIC的心理计量特性，包括其结构的内容和随时间的稳定性。从2008年（N = 3,761）到2010年（N = 3,040），在澳大利亚昆士兰州进行了基于人群的2型糖尿病患者前瞻性队列研究。参加者每年完成20项PACIC以及提供者遵守指南推荐的自我管理支持活动的措施。我们使用探索性因素分析来确定其因素结构，并检查内部一致性以及基线时PACIC与1年和2年后的随访重复测量之间的一致性。我们还使用多项逻辑回归确定了与准则相关的有效性，以探索PACIC与提供商的自我管理支持之间的联系。根据我们的发现，单因素结构被认为是最优的。随着时间的推移，在量表中观察到了很高的内部一致性和适度的一致性。较高的PACIC分数预示着提供商将获得更好的自我管理支持。总之，PACIC是评估糖尿病护理的可靠，有效且可重复的工具，我们建议将其作为单一量表而不是最初提议的子量表进行推广和使用。

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