目的：研究全科医疗特征功能测量工具基础保健评价工具-成人简短版( PCAT-AE）在我国社会文化和医疗卫生系统背景下的适用性。方法以PCAT-AE作为测试量表，采用“直接引入＋汉化＋局部修缮”方式进行本土化，形成的正式调查量表包括7个维度23个条目，7个维度分别为首诊利用、可及性、连续性、综合性、协调性、以家庭为中心、以社区为导向、文化背景胜任力。采用目的抽样法，抽取广东省广州市、深圳市及东莞市的8家社区卫生服务中心和1家公立医院全科医学门诊部；采用便利抽样法，选取这9家机构的全科门诊患者作为调查对象。于2014年8—9月，采用调查问卷进行调查，调查内容包括患者的一般情况和PCAT-AE两部分。共回收问卷1712份，有效问卷1645份，有效率为96.1％。采用Cronbach′sα、探索性分析检验量表的信度、结构效度，采用相关系数评价量表条目的内部一致性。结果量表总体Cronbach′sα为0.74；综合性、连续性、可及性3个维度的Cronbach′sα分别为0.63、0.72、0.67，协调性、以家庭和社区为导向、首诊利用的Cronbach′sα分别为0.58、0.47、0.40。经探索性因子分析，提取了首诊利用、可及性、快捷性、连续性、综合性、协调性、以家庭和社区为导向7个公因子，7个公因子的累计方差为55.62％。2个条目的载荷＜0.4，1个条目的得分与总得分之间的相关系数＜0.2。结论采用“直接引入＋汉化＋局部修缮”方式本土化的PCAT-AE，形成全科医疗特征功能测试量表，在我国具有一定的适用性。但需要深入探索研究符合我国背景的全科医疗特征功能的概念框架和理论模型，开发符合我国社会文化和医疗卫生体系的全科医疗特征功能评价量表。%Objective To investigate the suitability of primary care assessment tool for adult evaluation ( PCAT-AE) in the context of Chinese sociocultural environment and health care system.Methods The PCAT-AE was adopted and was translated into Chinese and slightly modified to adapt to the general practice in China.The formal scale included 7 dimensions and 23 items; the 7 dimensions were first contact care utilization, accessibility, continuity, comprehensiveness, coordination, family-orientation, community-orientation and cultural competence.Using cultural sampling method, the research took place in 8 community health centers ( CHCs) and one general outpatient clinic of a public hospital in Guangzhou, Shenzhen and Dongguan in Guangdong Province; using convenience sampling method, the patients of the outpatient clinics of the 9 settings were enrolled as subjects.From August to September in 2014, questionnaire survey was conducted, and the survey content included the general data and PCAT-AE of the patients.A total of 1 712 questionnaires were collected, and 1 645 questionnaires were effective with an effective rate of 96.1%.Reliability and construct validity of the scale were analyzed by Cronbach′s αand exploratory factor, and the internal consistency of the scale items was evaluated using correlation coefficients.Results The overall Cronbach′sαwas 0.74; the Cronbach′sαof the three dimensions of comprehensiveness, continuity and accessibility was 0.63, 0.72 and 0.67 respectively, and the Cronbach′s αof the three dimensions of coordination, family -orientation and community-orientation, first contact care utilization was 0.58, 0.47 and 0.40 respectively.By exploratory factor analysis, seven common factors were extracted including first contact care utilization, accessibility, rapidness, continuity, comprehensiveness, coordination, family-orientation and community-orientation; the cumulative variance of the seven factors was 55.62%, and two items had factors loadings <0.4; correlation coefficient between the factor score of one item and the total score was <0.2.Conclusion The modified PCAT-AE tool has moderate suitability for assessing primary care in the developing healthcare system in China.Efforts are needed to better define the conceptual frameworks and theoretical models that fit the core attributes of general practice in China and to develop the core-attribute measurement tool that aligns with Chinese social culture and health care system.
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