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脆弱な在宅患者のためのPRACTIC目標設定面接(PGSI)の開発。実現可能性、介在者間信頼性、および内容妥当性-混合研究法
Anette Væringstad1,2, Øyvind Kirkevold1,2,3, Ellen Thea Gjelseth Dalbak1,2
1The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway.
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まとめ
PRACTIC目標設定面接(PGSI)は、在宅ケアにおける患者のエンゲージメントと目標達成を高めるための、実現可能で妥当なツールです。本研究では、患者の転帰を改善するための内容妥当性と介在者間信頼性を確認しました。
科学分野:
- 老年学;保健サービス研究;心理測定学
背景:
- 目標設定面接は、Bangor目標設定面接(BGSI)のような、ランダム化比較試験(RCT)の参加者に個別化された結果を提供します。;PRACTIC RCTは、脆弱な在宅患者に対する生物心理社会 Intervention を評価しており、適応されたPRACTIC目標設定面接(PGSI)を主要な転帰として使用しています。;PGSIは、個々の目標達成と変化への準備に焦点を当て、患者固有のニーズを反映しています。
研究 の 目的:
- PRACTIC RCTで使用するために、BGSIからPGSIを翻訳および開発すること。;在宅ケア環境におけるPGSIの実現可能性、内容妥当性、および介在者間信頼性を調査すること。
主な方法:
- 定量的データと定性的データを統合した、収束混合研究法デザインを採用しました。;サブスタディ1では、自治体職員会議(n=7)のフィールドノートを使用して翻訳と開発を行いました。;サブスタディ2では、患者(n=126)、近親者(n=72)、スタッフ(n=13)、データ収集者(n=5)、および個人面接(n=12)を含む28の自治体からのデータを使用して、実現可能性、内容妥当性、および介在者間信頼性を評価しました。
主要な成果:
- PGSIは在宅ケアで好評を博し、時間的プレッシャーのような課題にもかかわらず、患者の関与を高めました。;モチベーションの高い参加者は12週間後にPGSIスコアが有意に増加しました(p=0.010)。;目標達成の患者評価とスタッフ評価の間には強い正の相関が見られました(Spearmanのρ = 0.87-0.92、p < 0.001)。これは高い介在者間信頼性を示しています。
結論:
- PGSIは、在宅ケアサービスにおける目標設定のための有用で実現可能なツールです。;PGSIは、患者のエンゲージメントと目標達成を強化します。;このツールは、患者ケアの改善をサポートする高い内容妥当性と介在者間信頼性を示しています。
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