Further Psychometric Testing and Validation of the Errors of Care Omission Survey (EoCOS)

进一步的心理测试和护理疏忽错误调查 (EoCOS) 的验证

• 批准号: 9164683
• 负责人: Lusine Poghosyan
• 金额: $ 4.99万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9164683
• 关键词: Further; Psychometric; Testing; Validation; Errors

Although a large proportion of healthcare care is delivered in primary care settings, research on patient safety in primary care has lagged behind that of inpatient care. Patient safety issues occur as frequently in primary care as in inpatient settings, but are not well studied. Moreover, the extant studies mainly focus on errors of commission—doing something wrong such as administering wrong medication—as opposed to errors of omission—failure of action such as missed care. Although omission errors outnumber commission errors and threaten patient safety, there is a critical gap in the literature on omission errors. This lack of evidence restricts the evaluation of clinical practice and challenges administrators', policy makers' and clinicians' abilities to make changes to promote patient safety. There are no reliable and valid tools to measure errors of care omission in primary care. We are developing the Errors of Care Omission Survey (EoCOS) through literature review, investigation of existing tools, interviews with primary care providers (PCPs), content validation, and pretesting to measure PCP perceptions of errors of care omission. Four domains underlying care omission are proposed: a) self-management support; b) follow-up; c) emotional health; and d) care integration. Each EoCOS subscale measures one domain through items asking PCPs to rate their perceptions on a 4-point scale. The purpose of the proposed study is to further evaluate the psychometric properties of the EoCOS and refine and validate the tool. Specific aims include 1) Determine the factorial structure of EoCOS and finalize the subscales measuring care omission domains; 2) Investigate performance of the items in EoCOS using Item Response Theory (IRT) models; and 3) Examine whether the items on each EoCOS subscale measure the intended construct by fitting data from different PCPs utilizing Confirmatory Factor Analysis (CFA). A cross-sectional survey design with a sample of PCPs (physicians and nurse practitioners) recruited in New York State will be used (n=1,328). Each PCP will receive a mailed survey along with cover letter, consent form, and a prepaid return envelope for returning the surveys to the research team. Post card reminders and a second mailing will be conducted to increase the response rate. SPSS, MPlus and IRTPro software will be used for data analysis. We will randomly split the sample into two: a derivation and a validation sample. Using data from the derivation sample, we will establish the factorial structure of the EoCOS using Exploratory Factor Analysis and assess the characteristics of each individual item using Item Response Theory models. Using the validation sample, we will test whether the emerged factor structure fits the data from this sample. These analytical procedures will assess the discriminant, convergent, and construct validity of the EoCOS and will produce sample invariant parameters. EoCOS may be used with various groups of PCPs for conducting meaningful comparisons of care omission errors across practices and states increasing the utility of the tool. This evidence will help create patient safety systems in primary care to make care omission errors visible so they can be corrected before harming patients.

尽管大部分医疗保健是在初级保健机构中提供的，但对患者安全的研究 初级保健中的患者安全问题发生频率落后于住院护理。 住院环境中的护理，但尚未得到充分研究，而且，现有的研究主要集中在错误上。 佣金——做错事，例如服用错误的药物——而不是错误 疏忽——行动失败，例如错过护理，尽管疏忽错误的数量超过了委托错误的数量。 患者的危险安全，在遗漏错误的文献中存在着严重的空白，这种证据的缺乏限制了这一点。 临床实践的评估并挑战管理者、政策制定者和忠诚者的能力 没有可靠有效的工具来衡量护理疏忽的错误。 我们正在通过文献回顾制定护理疏忽错误调查 (EoCOS)， 对现有工具的调查、对初级保健提供者 (PCP) 的访谈、内容验证和预测试 为了衡量 PCP 对护理遗漏错误的看法，提出了四个潜在的护理遗漏领域： a) 自我管理支持； c) 情绪健康；以及 d) 护理整合。 通过要求 PCP 以 4 分制评分的项目来衡量一个领域。 拟议的研究是为了进一步评估 EoCOS 的心理测量特性，并完善和验证 具体目标包括 1) 确定 EoCOS 的因子结构并最终确定测量分量表。 护理遗漏领域；2) 使用项目反应理论 (IRT) 调查 EoCOS 中项目的表现 模型；以及 3) 检查每个 EoCOS 子量表上的项目是否通过拟合来衡量预期的结构 使用验证性因子分析 (CFA) 收集来自不同 PCP 的数据 采用横断面调查设计。 将使用在纽约州招募的 PCP（医生和执业护士）样本（n=1,328）。 PCP 将收到邮寄的调查问卷以及求职信、同意书和预付费回邮信封 将调查问卷退回给研究团队并进行第二次邮寄。 提高回复率。我们将随机使用SPSS、MPlus和IRTPro软件进行数据分析。 将样本分为两部分：派生样本和验证样本，我们将使用派生样本中的数据。 使用探索性因子分析建立 EoCOS 的因子结构并评估特征 使用项目响应理论模型的每个单独项目，我们将测试是否。 出现的因子结构适合该样本的数据。这些分析程序将评估 EoCOS 的判别、收敛和构造有效性，并将产生样本不变参数。 EoCOS 可与各组 PCP 一起使用，对疏忽护理进行有意义的比较 跨实践和状态的错误增加了该工具的实用性，这将有助于创造患者安全。 初级保健系统使护理遗漏错误可见，以便可以在伤害患者之前纠正这些错误。