Cross-cultural adaptation, reliability and validity of GP-pharmacist collaboration assessment questionnaire
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摘要:
目的 全科医生与药师的协作是影响患者医疗质量的重要因素。全科医生对与药师协作的态度及协作频率评估问卷(ATCI-GP和FICI-GP)是分别用于评估全科医生对协作的态度和参与协作频率的科学工具,但该问卷尚未经过汉化。本研究将ATCI-GP与FICI-GP分别经过跨文化调适成为中文版问卷,并检验中文版问卷的信度和效度,旨在为评估全科医生与药师协作状况提供研究工具。 方法 本研究遵循跨文化调适指南和Brislin翻译原则,将ATCI-GP和FICI-GP跨文化调适为中文版问卷C-ATCI-GP、C-FICI-GP。采用方便抽样法,于2022年11月—2023年2月选取深圳市、杭州市、西安市、长沙市和北京市的25家基层卫生机构的全科医生进行调查,以分析该问卷的信度和效度。 结果 共回收问卷346份,其中有效问卷320份。C-ATCI-GP的整体Cronbach's α系数为0.958,C-FICI-G的整体Cronbach’s α系数为0.967。两份问卷所有条目的|CR值|均>3.000(P<0.001),各条目得分与量表总分的相关系数>0.300(P<0.001)。C-ATCI-GP的内容效度指数(S-CVI)为0.876。C-FICI-GP的内容效度指数(S-CVI)为0.882。结构效度分析显示,C-ATCI-GP共提取出2个公因子,累计方差贡献率达到了72.546%;C-FICI-GP共提取出1个公因子,方差贡献率为77.713%。 结论 经过本研究跨文化调适的C-ATCI-GP和C-FICI-GP具有良好的信度和效度,可作为国内研究者评估全科医生对与药师协作的态度与频率状况的可靠调查工具。 Abstract:Objective The collaboration between pharmacists and general practitioners (GPs) is essential to the quality of patient care. Attitudes toward collaboration instrument for GPs (ATCI-GP) and frequency of interprofessional collaboration instrument for GPs (FICI-GP) have been used to assess GPs' attitudes towards collaboration with pharmacists and their frequency of collaboration, respectively, yet they had not been validated in the Chinese version. To provide a research tool for assessing the collaboration between GPs and pharmacists, we translate ATCI-GP and FICI-GP into Chinese and test the reliability and validity of the Chinese version. Methods Following the guidelines for cross-cultural adaptation and the Brislin translation principle, the ATCI-GP and FICI-GP were translated into Chinese versions of questionnaires C-ATCI-GP and C-FICI-GP. From December 2022 to February 2023, a survey was conducted among general practitioners from 25 primary health institutions in Shenzhen, Hangzhou, Xi' an, Changsha, and Beijing to analyze the reliability and validity of the questionnaire by convenience sampling method. Results A total of 346 questionnaires were collected, of which 320 were valid. The overall Cronbach' s α coefficient for C-ATCI-GP was 0.958, and for C-FICI-G, it was 0.967. The |CR values| for all items in both questionnaires were greater than 3.000 (P < 0.001), and the correlation coefficients between item scores and the total scale score were greater than 0.300 (P < 0.001). The content validity index (S-CVI) for C-ATCI-GP was 0.876, and for C-FICI-GP, it was 0.882. The construct validity analysis showed that C-ATCI-GP extracted 2 common factors, accounting for a cumulative variance contribution rate of 72.546%, and C-FICI-GP extracted 1 common factor, accounting for a variance contribution rate of 77.713%. Conclusion The Chinese versions of ATCI and FICI have good reliability and validity and can be used as reliable evaluation tools for domestic researchers to evaluate the attitude and frequency of general practitioners towards collaboration with pharmacists. -
Key words:
- General practitioner /
- Pharmacists /
- Cross-cultural adaptation /
- Reliability and validity
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表 1 全科医生与药师协作状况评估问卷项目分析结果
Table 1. Item analysis of the Chinese version of GP-pharmacist assessment questionnaire
问卷条目 得分(x ± s,分) 条目鉴别度 条目得分与总分相关性 CR值 P值 r值 P值 ATCI-GP 1.我与药师在专业内容上的沟通是开诚布公的 4.41±0.72 -7.000 < 0.001 0.442 < 0.001 2.药师愿意与我一起管理患者的用药 4.29±0.67 -11.417 < 0.001 0.734 < 0.001 3.药师为患者提供了高质量的医疗健康服务 4.13±0.82 -11.810 < 0.001 0.761 < 0.001 4.药师有时间与我讨论有关患者用药方案的事宜 4.02±0.92 -10.121 < 0.001 0.739 < 0.001 5.药师的专业能力符合我对他(她)的期望 4.14±0.82 -10.477 < 0.001 0.732 < 0.001 6.我可以相信药师做出的专业决策 4.11±0.82 -7.760 < 0.001 0.672 < 0.001 7.药师积极地解决患者的用药问题 4.20±0.75 -12.587 < 0.001 0.758 < 0.001 8.药师和我在专业层面上互相尊重 4.42±0.63 -10.128 < 0.001 0.719 < 0.001 9.药师和我在治疗患者方面有共同的目标 4.46±0.62 -9.376 < 0.001 0.678 < 0.001 10.我和药师在患者治疗上的职责分工是明确的 4.30±0.74 -10.191 < 0.001 0.781 < 0.001 11.我信任药师在药物治疗方面的专业性 4.33±0.69 -10.152 < 0.001 0.752 < 0.001 12.药师在确保用药安全方面发挥了作用(例如,识别药物相互作用、不良反应、禁忌证等) 4.31±0.65 -12.805 < 0.001 0.764 < 0.001 13.药师在确保药物有效性方面发挥了作用(例如,确保患者获得最合适的药物且剂量合理等) 4.30±0.65 -14.186 < 0.001 0.772 < 0.001 FICI-GP 1.我和药师彼此坦诚地沟通交流 2.90±0.96 -12.818 < 0.001 0.734 < 0.001 2.药师向我告知可使用的新药物或他们可以提供的服务 2.87±1.00 -15.851 < 0.001 0.818 < 0.001 3.我联系药师了解具体的药物信息 2.89±0.93 -14.489 < 0.001 0.824 < 0.001 4.我向药师了解患者的具体信息 2.68±1.10 -14.040 < 0.001 0.827 < 0.001 5.药师向我确认处方的内容 3.11±0.92 -9.727 < 0.001 0.698 < 0.001 6.药师联系我讨论药物剂量的调整 2.79±0.99 -9.751 < 0.001 0.764 < 0.001 7.药师向我推荐了替代药物(例如,由于不良反应、禁忌证等) 2.64±1.10 -14.530 < 0.001 0.815 < 0.001 8.我在药师的建议下调整了患者的用药 2.60±1.00 -12.800 < 0.001 0.804 < 0.001 9.我向药师分享了患者信息 2.72±1.10 -14.119 < 0.001 0.780 < 0.001 10.我让药师参与有关用药管理的决策 2.69±1.00 -17.440 < 0.001 0.845 < 0.001 注:CR值=决断值。 表 2 全科医生与药师协作状况评估问卷各条目的因子载荷值
Table 2. The factor loading values for every item in the Chinese version of GP-pharmacist assessment questionnaire
问卷条目 公因子 公因子1 公因子2 ATCI-GP 11.我信任药师在药物治疗方面的专业性 0.865 - 7.药师积极地解决患者的用药问题 0.855 - 13.药师在确保药物有效性方面发挥了作用(例如,确保患者获得最合适的药物且剂量合理等) 0.850 - 5.药师的专业能力符合我对他(她)的期望 0.834 - 12.药师在确保用药安全方面发挥了作用(例如,识别药物相互作用、不良反应、禁忌证等) 0.833 - 3.药师为患者提供了高质量的医疗健康服务 0.828 - 6.我可以相信药师做出的专业决策 0.807 - 10.我和药师在患者治疗上的职责分工是明确的 0.802 - 4.药师有时间与我讨论有关患者用药方案的事宜 0.789 - 1.我与药师在专业内容上的沟通是开诚布公的 - 0.840 8.药师和我在专业层面上互相尊重 - 0.737 9.药师和我在治疗患者方面有共同的目标 - 0.704 2.药师愿意与我一起管理患者的用药 - 0.655 FICI-GP 7.药师向我推荐了替代药物(例如,由于不良反应、禁忌证等) 0.914 10.我让药师参与有关用药管理的决策 0.913 9.我向药师分享了患者信息 0.907 8.我在药师的建议下调整了患者的用药 0.902 4.我向药师了解患者的具体信息 0.900 6.药师联系我讨论药物剂量的调整 0.888 3.我联系药师了解具体的药物信息 0.884 1.我和药师彼此坦诚地沟通交流 0.833 2.药师向我告知可使用的新药物或他们可以提供的服务 0.832 5.药师向我确认处方的内容 0.804 注:“- ”表示在此公因子上的载荷值< 0.500。 -
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