Background China's current healthcare service quality evaluation system is mainly for urban healthcare services,but not for the elderly care institutions including those deliver integrated medical and nursing care services.Objective To develop a Service Quality Assessment Scale for Integrated Medical and Nursing Care Services Delivered by Elderly Care Institutions and test its reliability and validity,in order to provide a theoretical basis for health administration and other relevant departments to formulate the corresponding policies.Methods Based on literature review,expert scoring and pre-investigation,we developed a Service Quality Assessment Scale for Integrated Medical and Nursing Care Services Delivered by Elderly Care Institutions including 29 items,and 5 factors (dimensions) of hardware facilities and environment,operation management,security protection,humanistic care and basic health.From March to May 2017,we mailed 1 218 questionnaires to elderly care institutions located in large and medium-sized cities of China (774 questionnaires for 258 elderly care institutions in Jiangsu Province and 444 questionnaires for 148 elderly care institutions in Shanghai).A total of 825 questionnaires were returned,and 501 (60.7％) of them were responsive.And the reliability and validity of the Service Quality Assessment Scale for Integrated Medical and Nursing Care Services Delivered by Elderly Care Institutions were analyzed.Results The KMO value of the scale was 0.798,Bartlett's Test of Sphericity showed x2 =3 763.128,df =406,P ＜ 0.001,indicating that it was suitable for confirmatory factor analysis.The Spearman-Brown split-half coefficient,Cronbach's α and Guttman split-half coefficient of the scale were 0.830,0.918 and 0.814,respectively,which indicated that the reliability of the scale was acceptable.The expert consultation and scoring conducted during the development of the scale,and the Cronbach'st coefficients of all the 29 items were ＞ 0.90,which showed that the content validity of the scale was reliable.The construction validity test showed that most inter-item correlation coefficients were about 0.60,indicating the construct validity of the scale was good.Conclusion The Service Quality Assessment Scale for Integrated Medical and Nursing Care Services Delivered by Elderly Care Institutions presents good reliability and validity in this study.However,its reliability and validity need to be tested further in elderly care institutions of different sizes in different cities and provinces,by which,the scale will be more reliable and valid.%背景 我国现有的卫生评价内容主要是针对城市医疗服务,并没有专门针对养老机构服务质量的评价体系,而医养结合模式下养老机构同时兼顾医疗的特殊性与养老的服务性,因此更需要该方面的评价体系.目的 研制医养结合模式下养老机构服务质量评价量表,并进行信效度检测,为卫生行政及其他相关部门制定相应的政策提供理论依据.方法 基于文献回顾、专家打分、预调查等方法构建医养结合模式下养老机构服务质量评价量表,共29个条目、5个因子(即5个维度),分别命名为硬件设施及环境、运营管理、安全防护、人文关怀、基本健康.2017年3-5月,基于兼顾大中城市的原则,采取邮寄形式向江苏省内258所养老机构投递774份问卷,上海市148所养老机构投递444份问卷.共计发放问卷1 218份,收回问卷825份,有效问卷501份,有效回收率为60.7％.分析医养结合模式下养老机构服务质量评价量表的信度和效度.结果 医养结合模式下养老机构服务质量评价量表的KMO值为0.798,Bartlett’s球形检验x2=3 763.128,df=406,P＜0.001,表明适合做验证性因子分析.医养结合模式下养老机构服务质量评价量表的皮尔曼-布朗折半指数为0.830,Cronbach's α系数为0.918,Guttman折半信度系数为0.814,表明医养结合模式下养老机构服务质量评价量表信度较高.医养结合模式下养老机构服务质量评价量表开发过程中进行了专家咨询和打分,且量表中29个条目的Cronbach's α系数均＞0.90,内容效度可靠.经结构效度检验得出,绝大多数条目与条目间的相关系数在0.60左右,表明其结构效度较好.结论 本研究设计的医养结合模式下养老机构服务质量评价量表具有较好的信度与效度,但还需进一步在不同省市、不同规模的养老机构中对其应用效果进行检验,进而形成一个更为可靠、有效的养老机构服务质量评价体系.
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