Data_Sheet_2_Developing a Tool to Measure Person-Centered Care in Service Planning.CSV

Background: Delivering person-centered care is a key component of health care reform. Despite widespread endorsement, medical and behavioral health settings struggle to specify and measure person-centered care objectively. This study presents the validity and reliability of the Person-Centered Care Planning Assessment Measure (PCCP-AM), an objective measure of the extent to which service planning is person-centered.
Methods: Based upon the recovery-oriented practice of person-centered care planning, the 10-item PCCP-AM tool rates service plans on the inclusion of service user strengths, personal life goals, natural supports, self-directed actions and the promotion of community integration. As part of a large randomized controlled trial of person-centered care planning, service plans completed by community mental health clinic providers were rated using the PCCP-AM. Reliability was tested by calculating inter-rater reliability across 168 plans and internal consistency across 798 plans. To test concurrent validity, PCCP-AM scores for 84 plans were compared to expert rater scores on a separate instrument.
Results: Interrater reliability for each of the 10 PCCP-AM items as measured by Kendall's W ranged from W = 0.77 to W = 0.89 and percent of scores within ± 1 point of each other ranged from 85.7 to 100%. Overall internal consistency as measured by Cronbach's alpha across 798 plans was α = 0.72. Concurrent validity as measured by Kendall's W ranged from W = 0.55 to W = 0.74 and percent of item scores within ± 1 point of expert rater scores ranged from 73.8 to 86.8%.
Conclusions: Findings demonstrated that the 10-item PCCP-AM was a valid and reliable objective measure of person-centered care. Using the service plan as an indicator of multiple domains of person-centered care, the measure provides a valuable tool to inform clinical supervision and quality improvement across programs. More psychometric testing is needed to strengthen the measure for research purposes.

研究背景：提供以患者为中心的照护是医疗改革的核心组成部分。尽管该理念已获得广泛认可，但医疗与行为健康机构仍难以明确界定并客观量化以患者为中心的照护。本研究针对以患者为中心的照护规划评估量表（Person-Centered Care Planning Assessment Measure，PCCP-AM）的效度与信度展开分析，该量表可客观衡量服务规划的以患者为中心程度。
研究方法：本量表基于以患者为中心的照护规划的康复导向实践，共包含10个条目，用于评估服务规划是否纳入服务对象的优势、个人生活目标、自然支持系统、自主行动以及社区融合促进情况。本研究作为以患者为中心的照护规划大型随机对照试验的一部分，采用PCCP-AM对社区精神卫生诊所服务人员制定的服务规划进行评分。信度检验通过计算168份服务规划的评定者间信度，以及798份服务规划的内部一致性完成。同时，为检验效标关联效度，将84份服务规划的PCCP-AM评分与另一款工具的专家评定者评分进行对比。
研究结果：PCCP-AM的10个条目经肯德尔和谐系数（Kendall's W）检验，评定者间信度的W值介于0.77至0.89之间；评分相差不超过1分的占比范围为85.7%至100%。798份服务规划的总体内部一致性经克朗巴哈α系数（Cronbach's alpha）检验，α值为0.72。效标关联效度经肯德尔和谐系数检验，W值介于0.55至0.74之间；条目评分与专家评定者评分相差不超过1分的占比范围为73.8%至86.8%。
研究结论：本研究结果表明，10条目版PCCP-AM是一款可靠且有效的以患者为中心的照护客观量化工具。该量表以服务规划作为以患者为中心照护多维度的评估指标，可为各项目的临床监管与质量提升提供实用工具。未来仍需开展更多心理测量学检验，以优化该量表的科研应用价值。