医患沟通质量量表设计及评价

Scale development and assessment of the physician-patient communication quality

目的：设计适合我国医院使用的医患沟通质量评价指标和评价工具。方法研究采用问卷调查的方法,通过对问卷的定量数据分析来检验量表的信度和效度。结果研究设计了有3个维度22个项目构成的《医患沟通质量评价量表》初稿,以随机抽样的方法选择了5家综合性医院,发放问卷1800份,回收有效问卷1400份,量表部分完整问卷559份,对559份问卷进行了探索性因子分析和验证性因子分析,探索性因子分析并没有验证设想的3个维度,而是将22个项目降维为5个维度：诊断信息、治疗信息、费用沟通、移情性和沟通结果。验证性因子分析 RMSEA、GFI、PGFI、IFI和 CFI 指标分别是0.066、0.895、0.704、0.916、0.915,显示5维度模型有较好的适配度。该量表 Cronbach α信度为0.924,5个维度的 Cronbach α信度和组合信度均在0.7以上,AVE 均接近或者超过0.5,维度间相关系数的平方值均接近或者小于相关维度的 AVE。结论实证分析结果显示量表具有较好的内部一致性、收敛效度和区别效度,模型适配较好。

Objective To develop an instrument being applicable for Chinese hospital to evaluate the physician- patient communication. Methods Study ran instrument scrip with 3 dimensions and 22 items. Questionnaire survey was operated and tested scale’s reliability and validity based on the quantitative analysis on the questionnaire. Results A random sample coming from 5 hospitals was used, and distributed 1800 questionnaires, 1400 was valid, and 559 questionnaires were fully filled in. Ex-ploring factor analysis （EFA） and Confirmatory factor analysis （CFA） were employed. EFA examined 5 dimensions： therapy in-formation, diagnosis information, treatment information, expenditure communication and empathy. RMSEA, GFI, PGFI, IFI and CFI were 0. 066、0. 895, 0. 704, 0. 916, and 0. 915 respectively, and result of CFA showed 5dimension model good fitness. Cronbach-α coefficient of scale was 0. 924, each Cronbach-α coefficient and composite reliability coefficients of 5 dimensions was above 0. 7, AVE was much close to or higher than 0. 5, and square of relation coefficient among 5 dimensions was close or less than corresponding AVE. Conclusion The rating scale with 5 dimensions had good model fitness, good internal reliability, con-vergent validity, and discriminant validity.