住院医师职业素养与组织承诺相关性研究

目的 研究职业素养与组织承诺之间关联程度及因素,提供建设性意见和改进措施。方法 针对医院2012—2013届住院医师150名学员进行职业素养及其相关因素调查,回收完整填写量表149份,回收率99.3%。运用多元线性回归分析住院医师职业素养与组织承诺关联性及影响。结果 医院住院医师职业素养总体处于中等水平,在领导力、逆商、工作环境维度自我评估较低。组织承诺处于中等偏下水平,且与组织承诺关联程度从强到弱依次是人际关系、工作环境、逆商、核心价值观。结论 医院住院医师职业素养总体尚可,但组织承诺总体状况持较不乐观态度,建议改进“住院医师规培”工作,同时建立预警机制防止优秀住院医师流失。     

医院青年管理人员职业素养评估量表的设计与分析

目的 探索建立医院青年管理人员职业素养评估量表,并对其信度、效度进行评价。方法 在充分查阅文献、专家访谈咨询的基础上设计评估量表,调查对象为江苏省13家三级医院专兼职管理人员,共收回有效问卷507份。结果 评估量表的总Cronbach’s α系数为0.984,4个维度的Cronbach’s α系数均大于0.800;因子分析结果提取5个公因子,其中3个基本与预设纬度“职业基本道德”、“职业态度与意识”、“职业行为与习惯”相吻合,另两个公因子分别对应“职业知识与技能”的知识与技能两部分,可以考虑将评估量表分为5个纬度。结论 医院青年管理人员职业素养评估量表具有较好的信度,评估条目较为合理,结构效度较好,具有一定的现实应用意义。     

脑卒中患者满意度量表中文修订版的信效度检验研究

目的 构建有良好测量学属性的中文版本的脑卒中患者满意度量表,适用于对中国脑卒中患者的医疗服务满意度进行测量。方法 从上海市5家综合医院中随机抽取300位脑卒中患者进行问卷,得到280份有效问卷,回收率93.3%。运用主成分分析、KM0检验和巴特利球体检验及因子分析对量表进行测评,以此获得量表的信效度。结果 条目分析将条目16剔除;KMO指数为0.854,探索性因子分析验证量表修订版也包括两个因子：住院治疗服务满意度和居家康复服务满意度,两因子解释总变异的70.1%;验证性因子分析验证量表的各项拟合指标良好。中文版本脑卒中患者满意度量表得分总数与医疗服务满意度总分数显著正相关,与Barthel日常生活功能评估指数得分和自我健康功能评估得分低程度显著正相关。总量表的Cronbach’s α系数为0.85,重测信度系数为0.83。结论 中文版本的脑卒中患者满意度量表信度和效度均良好,适用于国内脑卒中患者进行满意度的专门测量。     

医生职业倦怠量表的编制及信效度检验

目的:编制医生职业倦怠量表.方法:通过查阅文献、访谈及专家讨论,建立量表结构,并确定初始量表项目48条.在西安的两所三级甲等医院施测,2次分别选取176和436名医生作为样本.采用项目分析、探索性因素分析、信度分析、验证性因素分析等统计方法对数据进行统计分析.结果:医生职业倦怠量表由六个因素构成:疲劳感、工作能力下降、投入性下降、成就感降低、工作控制感下降以及工作前景.共有30个项目,量表总分与各因素之间的相关系数0.541～0.856(P＜0.001).六个因素的α系数在0.886～0.896之间,总量表的α系数为0.894.验证性因素分析拟合度较高(RESEA=0.062,GFI=0.859,CFI=0.842,IFI=0.851).医生职业倦怠量表总分及各因子分与工作倦怠问卷的总分及各因子分之间具有显著的相关性(P＜0.05).结论:编制的医生职业倦怠量表信度和效度符合心理测量学要求,可以作为医生职业倦怠测量的工具.     

中国医院住院患者体验和满意监测量表的信效度评价

目的 评价“中国医院住院患者体验和满意监测量表”的信度与效度,为改进量表、推广应用提供依据。方法 采用邮寄方式对出院患者进行问卷调查,使用SPSS数据分析软件,分别对量表的内部一致性、折半信度、内容效度及结构效度进行评价。结果 量表总体Cronbach’s ɑ系数为0.956,所包含6个维度的Cronbach’s ɑ系数均大于0.8。分半信度为0.971。各条目与量表总体的相关系数介于0.51~0.79之间。以所有条目为变量进行因子分析,共提取5个公因子,其累计贡献率为66.2%,各条目至少在其中一个公因子上负荷值大于0.4。结论 量表具有良好的信度和效度,适用于中国医院住院患者满意度的测评。     

综合医院市场导向测评量表的研制

目的 探索和开发我国医院市场导向测评量表,了解医院服务模式在理念和行动方面的现状。方法 课题组采用外部引进、内部调整的方法形成我国综合医院市场导向的测评量表,对20家三级综合医院展开现场调查。结果 量表包含3个维度：顾客满意、市场信息的产生和传播、对市场信息的反应;内部一致性信度为0.898,运用因子分析检验建构效度,前3个因子累积解释了67.81%的信息;顾客满意维度评分高于对市场信息的反应,市场信息的产生和传播评分较低;不同岗位的员工对市场导向观念评分差异存在统计学意义。结论 研制的量表具有较好的信度、内容效度和建构效度,能较好地反映不同医疗机构的市场导向现状和差异。     

门诊患者满意度测评量表的研制及验证研究

目的 针对当前学术界及实践工作者聚焦关注的患者满意度测评,以及文献综述发现其门诊患者测评量表在医疗服务技术及费用核心要素设计上,普遍存在指标粗略、患者难以理性判断等问题,修正研制完善其测评量表并进行信效度评价。方法 运用文献资料及专题小组讨论法,从患者能够理性体验和客观判断的视角研制该量表,并对浙江省8家综合医院421名门诊患者进行问卷调查,采用内部一致性检验、Spearman相关分析和因子分析等方法评价量表的信效度。结果 量表总体的分半信度为0.96,Cronbach’s α系数为0.94,量表五个维度的Cronbach’s α系数在0.84～0.87之间;因子分析共提取“服务环境”“服务效率”“服务态度”“服务技术”“医疗费用”5个公因子,方差累计贡献率为71.66%。结论 修正研制的门诊患者满意度测评量表侧重及细化设计丰富了医疗服务技术及费用维度的条目内容,总体及各维度信效度均较好,可作为医院门诊医疗服务效果社会评价及治理的参考工具。     

医务人员工作满意度测评量表的研制及验证研究

目的 针对当前学术界及实践工作者聚焦关注的医务人员工作满意度测评,以及文献综述发现其测评量表忽视和缺失考察了患方及社会舆论因素对其满意度的影响以及医患满意协同的作用,修正研制完善其测评量表并进行信效度评价。方法 运用文献资料及专题小组讨论法编制医务人员工作满意度量表,并对浙江省8家综合医院573名医务人员进行问卷调查,采用内部一致性检验、Spearman相关分析和因子分析等方法对量表信度、效度进行评价。结果 量表的内部一致性系数为0.917,分半信度为0.953,各条目得分与总体得分相关系数在0.403～0.759之间(P＜0.01);因子分析发现量表6个维度结构较为合理,可累积解释总体方差变异的72.89%。结论 量表在条目设计上弥补了患者对医务人员的尊重、认可、信任及社会舆论环境等因素对其满意度影响的考察,总体及各维度信效度较好,可作为医务人员工作满意度测评及治理的参考工具。     

学龄儿童家庭食物环境评价工具构建及信效度分析

目的：构建学龄儿童家庭食物环境评价工具,并对其进行信效度分析。方法：运用文献分析和专家访谈法初步构建家庭食物环境评价工具,共包括6个维度（家庭社会人口学特征和经济状况、家庭喂养模式、家庭食物规则、家庭饮食行为、家长营养素养、家庭食物可及性）和54道题目。选择北京市1所公立小学1~5年级学生家长进行评价工具问卷调查。结果：599名学生家长参与调查,其中98.7%为父/母亲。根据题目筛选标准,删除7道题目,保留47道题目。问卷的内部一致性信度（Cronbachs α系数）为0.78,分半信度为0.84;内部一致性效度分析结果显示,家庭食物环境总分与各维度得分的相关系数均大于各维度之间的相关系数;探索性因子分析提取15个因子,累计方差贡献率为62.33%;验证性因子分析结果为χ2/df=1.97、GFI=0.88、AGEI=0.85、NFI=0.86、IFI=0.92、CFI=0.92、RMR=0.03、RMSEA=0.04、P=1.00。结论：本研究构建的学龄儿童家庭食物环境评价工具信效度较好,可用于评价学龄儿童家庭食物环境。     

Testing for Validity and Reliability in Cross-Cultural Research

A set of procedures is offered for assessing interraler reliability and certain aspects of validity of codes in cross-cultural studies. The method assumes that at least two independent raters have coded more than one trait. Each trait coded by one rater is correlated with each trait coded by a second, and all the codings by a single rater are intercorrelated with each other. The results are presented in a multitrait-multi-rater matrix. From this matrix it is possible to determine the interrater reliability and discriminant validity of trails in addition to a higher order concept based on pairs of traits.     

综合性医院初级医生全科化培养探讨

简要概述了国外医院住院医师培养,总结了当前医院在初级医生培养中存在的问题。以南京军区南京总医院为例,着重从制度保障、培训内容、培训方式3个方面论述了初级医生全科化培养模式的实践方法。     

The German Version of the Gaze Anxiety Rating Scale (GARS): Reliability and Validity

Objective

Fear of eye gaze and avoidance of eye contact are core features of social anxiety disorders (SAD). To measure self-reported fear and avoidance of eye gaze, the Gaze Anxiety Rating Scale (GARS) has been developed and validated in recent years in its English version. The main objectives of the present study were to psychometrically evaluate the German translation of the GARS concerning its reliability, factorial structure, and validity.

Methods

Three samples of participants were enrolled in the study. (1) A non-patient sample (n = 353) completed the GARS and a set of trait questionnaires to assess internal consistency, test-retest reliability, factorial structure, and concurrent and divergent validity. (2) A sample of patients with SAD (n = 33) was compared to a healthy control group (n = 30) regarding their scores on the GARS and the trait measures.

Results

The German GARS fear and avoidance scales exhibited excellent internal consistency and high stability over 2 and 4 months, as did the original version. The English version’s factorial structure was replicated, yielding two categories of situations: (1) everyday situations and (2) situations involving high evaluative threat. GARS fear and avoidance displayed convergent validity with trait measures of social anxiety and were markedly higher in patients with GSAD than in healthy controls. Fear and avoidance of eye contact in situations involving high levels of evaluative threat related more closely to social anxiety than to gaze anxiety in everyday situations.

Conclusions

The German version of the GARS has demonstrated reliability and validity similar to the original version, and is thus well suited to capture fear and avoidance of eye contact in different social situations as a valid self-report measure of social anxiety and related disorders in the social domain for use in both clinical practice and research.     

Factor Analysis of the Caregiver Quality of Life Index-Cancer (CQOLC) Scale for Chinese Cancer Caregivers: A Preliminary Reliability and Validity Study of the CQOLC-Chinese Version

The English version of the Caregiver Quality of Life Index-Cancer (CQOLC) was translated into simplified Chinese (CQOLC-C), following cultural translation, back-translation and pretest steps. Three hundred and sixty one cancer caregivers participated in this study. Cronbach’s alpha was used to assess CQOLC-C reliability. Exploratory factor analyses (EFA) was used to generate two models of the measure’s factor structure, and confirmatory factor analyses (CFA) were used to test each model, such that the best model to explain the latent structure of the CQOLC-C was identified. EFA using different factor extraction methods yielded two models including four and eight factors. According to the CFA results, model 2 was better fit for the original study data, based on the RMSEA criterion [0.058(90% CI = 0.051-0.065)], χ² (531) = 853.92, p < 0.0001; CFI (0.96), NNFI (0.96), IFI (0.97), and NFI (0.92). We also examined the effect of removing three items on the CQOLC-C factor structure and discuss the resulting differences from other versions. These results indicate that the CQOLC-C’s factor structure does not fully fit the original theorized model. This study provides preliminary support for further use of the CQOLC-C. However, the present work provides only partial support for the relevance and construct validity of the scale for Chinese caregivers.     

Validity of the Morningness-Eveningness Scale for Children among Spanish adolescents

Adolescents tend to be much later chronotypes than other age groups. This circadian phase delay is attributed as much to biological as psychosocial factors. Because the consequences of this change on performance and health have been documented, questionnaires to identify morning and evening-type adolescents are necessary. The aim of the present study was to validate a Spanish version of the Morningness-Eveningness Scale for Children (MESC) by means of several relevant psychological variables as external criteria. A sample of 623 urban high school students completed the MESC and self-reported measures of sleep behaviors, subjective alertness, physical performance, and mood. On the whole, results indicate a good validity of MESC. Significant differences in the self-reported ratings between morning and evening types were obtained by time-of-day. These results provide preliminary support for the Spanish version of MESC.     

Validity and Reliability of the Dutch Adaptation of the Psoriatic Arthritis Quality of Life (PsAQoL) Questionnaire

Objective

The Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire is a disease- specific instrument developed to measure quality of life (QoL) in patients with psoriatic arthritis (PsA). The aim of this study was to translate the measure into Dutch and to determine its psychometric properties.

Method

Translation of the original English PsAQoL into Dutch was performed by bilingual and lay panel. Ten field-test interviews with PsA patients were performed to assess face and content validity. In total, 211 PsA patients were included in a test-retest postal survey to investigate the reliability and construct validity of the Dutch adaptation of the PsAQoL. The PsAQoL, Health Assessment Questionnaire (HAQ) and Skindex-17 were administered on two different occasions approximately two weeks apart.

Results

The Dutch version of the PsAQoL was found to be relevant, understandable and easy to complete in only a few minutes. It correlated as expected with the HAQ (Spearman’s ρ = 0.72) and the 2 subscales of the Skindex-17 (ρ = 0.40 for the psychosocial and ρ = 0.46 for the symptom scale). Furthermore, the measure had good internal consistency (Cronbach’s α = 0.92) and test-retest reliability (ρ = 0.89). The PsAQoL was able to define groups of patients based on self-reported general health status, self-reported severity of PsA and flare of arthritis. Duration of PsA did not influence PsAQoL scores.

Conclusions

The Dutch version of the PsAQoL is a valid and reliable questionnaire suitable for use in clinical or research settings to asses PsA-specific QoL.