全科医疗评估问卷在社区卫生服务患者满意度调查中的应用与评价

Application and evaluation of general practice assessment questionnaire Chinese version for patients＇ satisfaction in community health-care service

目的探讨全科医疗评估问卷（GPAQ）2，0就诊咨询版在社区卫生服务中对患者满意度评价的应用。方法由3名全科医学领域专家翻译和反翻译GPAQ2．0就诊咨询版，形成GPAQ2．0就诊咨询中文版。从北京大兴、南菜园、永宁、韩村河4个社区卫生服务中心，分别随机抽取在2008年4月25日出诊的10名全科医生作为患者对全科医疗服务满意度评价的对象，由此40名医生在该日内各自所诊治的前30例患者（共1200例，年龄≥16岁）用GPAQ2．0就诊咨询中文版调查问卷进行患者满意度调查，评价其信度与效度。结果GPAQ2．0就诊咨询中文版5个评价方面信度分析的克朗巴赫（cronbach）α系数为0．734-0．813，特征值〉1的公因子有3个，累积贡献率为58．722％。接诊人员的帮助、可及性、持续性、医生的交流能力和自我照顾能力等5方面的得分，均比英国国家基准分低（t值分别为-6．397，-11．729，-6．328，-59．871，-2．210，均P〈0．05）。结论GPAQ2．0中文版具有较好的信度，效度尚可，可在适当修订后作为我国社区卫生服务质量患者满意度的评价工具。

Objective To study application of Chinese general practice assessment questionnaire （GPAQ） consultation version 2. 0 in evaluating patients＇ satisfaction with community health-care service （CHS）. Methods First, original GPAQ consultation version 2. 0 in English was translated into Chinese language by three experts in general practice/family medicine field, then translated it back into English, finally a Chinese version of GPAQ was formed. Ten medical doctors who were on duty on 25 April, 2008 at each out-patient clinic from CHS of Daxing, Nancaiyuan, Yongning and Hancunhe were selected randomly as targets for evaluation of service satisfaction. A sample of the first 30 patients （ 1200 in total） aged more than 16 years who visited the clinic on that day were selected to fill out the Chinese GPAQ consultation version 2. 0 to express their satisfaction with the medical doctors they visited, and reliability and validity of the questionnaire was then evaluated. Results Cronbach＇s alpha ranged 0. 734 to 0. 813 for each domain of the Chinese version of GPAQ2. O, and cumulated contribution of three common factors with the eigen-value more than one reached 58. 722%. Scores of patients＇ satisfaction with ＂receptionists＂, ＂access＂, ＂continuity＂, ＂doctor＇s communication skills＂ and ＂patient enablement＂ were significantly lower, as compared to those of national bench-mark in the United Kingdom, with t-values of -6. 397, - 11. 729, -6. 328, -59. 871 and - 2. 210, and all P 〈 0. 05, respectively. Conclusions The Chinese version of GPAQ 2. 0 achieves good reliability and moderate validity, and can be used as an instrument for evaluating patient＇s satisfaction with quality of CHS in China as further revision in the future studies.