連續性照護量表之發展與信效度檢定－於老年慢性病患出院準備服務之運用

Validation and Reliability Testing of the Patient Continuity of Care Questionnaire in Elderly with Chronic Diseases in Taiwan

陳曉梅(Hsiao‐Mei Chen) ； 曾勤媛(Chyn‐Yuan Tzeng) ； 陳靜敏(Ching‐Min Chen) ； 紀珮君(Pei‐Chun Chi) ； 葉芳枝(Fang‐Chin Yeh)

《護理暨健康照護研究》 9卷4期 (2013/12) Pp. 261-270

https://doi.org/10.6225/JNHR.09.4.261

摘要

背景：隨著我國老人慢性病人口快速成長，片段化醫療照護問題日益嚴重，連續性照護為我國重要照護目標，但我國測量連續性照護之量表尚無嚴謹的研究檢驗。目的：發展中文版連續性照護量表，進一步驗證其使用於台灣老年慢性病患出院準備服務之適用性。方法：經徵得同意引用後，進行外文量表之中文版發展過程。先經中文翻譯、翻譯後整合、反向翻譯、專家共識及訂版前預試之五個發展步驟後，以中部某區域醫院63位接受出院準備服務介入措施之慢性病老人病患進行量表之心理特性檢定，包括內容效度及同時關聯效度之效度檢定，及以內在一致性、兩週後再測信度進行量表信度之檢測。結果：經11位專家進行內容效度檢定，內容效度指標（content validity index）為.93，達可接受範圍；且連續性照護量表與生活品質心理範疇、社會關係及環境因素範疇皆呈顯著正相關，具同時關聯效度。在信度部分，量表的內在一致性其Cronbach's α值為.88－.94，再測信度.80－.91，顯示此量表具有良好的信效度。結論／實務應用：本研究證實翻譯版的連續性照護量表具可接受的信效度，並且可以做為台灣醫療機構慢性疾病老人連續性照護品質監測之工具。中文版連續性照護量表將可以廣泛應用於臨床服務或研究，期使病患得到更完善之健康照護。

關鍵字

出院準備服務 ； 慢性病老人 ； 連續性照護 ； 連續性照護量表

並列摘要

Background: The rapid increase in the number of elderly patients with chronic diseases has made caring for this vulnerable population a priority healthcare issue in Taiwan. The Patient Continuity of Care Questionnaire (PCCQ) has been widely used in international studies. However research has not yet assessed the suitability and applicability of the PCCQ in Taiwan.Purpose: The present study develops a Chinese‐language version of the PCCQ and investigates its usefulness in discharge planning for elderly patients with chronic diseases in Taiwan.Methods: After obtaining permission from the original author, the Chinese‐language version of PCCQ was developed in a 5‐step process. This process included: translation into Chinese, post‐translation integration, back translation, expert consensus, and testing of the pre‐final version. Sixty‐three elderly patients at a hospital in Central Taiwan with chronic diseases and a hospital discharge plan were enrolled for psychometric testing of the pre‐final Chinese‐language PCCQ. Content validity and concurrent validity were tested. Internal consistency and test‐retest reliability were measured in two‐week, post‐hoc assessments to ensure scale reliability.Results: A review by 11 experts gave the scale a content validity index (CVI) of .93. A significant positive correlation between PCCQ and quality of life (World Health Organization Quality of Life, WHOQOL) in the psychological, social relationship, and environmental domains demonstrate concurrent validity. An internal consistency of .88-.94 of the Cronbach's α coefficient and test‐retest scores of .80-.91 demonstrate good reliability and validity for the scale, respectively.Conclusions/Implications for Practice: This study confirmed that the Chinese‐version PCCQ has acceptable reliability and validity and may be used in Taiwan's health care institutions as a continuity‐of‐care measurement tool for the elderly with chronic diseases. The PCCQ may be used broadly to evaluate clinicalservice quality. Further research is necessary to enhance healthcare services in Taiwan.

並列關鍵字

discharge planning ； elderly with chronic conditions ； continuity of care ； patient continuity of care questionnaire

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