基于德尔菲法和层次分析法构建医院药师工作满意度量表

目的:构建医院药师工作满意度量表.方法:采用文献分析及德尔菲(Delphi)专家函询法相结合,建立医院药师工作满意度指标体系,构建量表,并运用层次分析法确定各级指标的权重.结果:专家权威系数为0.844,专家的权威程度较高,熟悉程度为0.783,判断系数为0.904,各级指标的肯德尔协调系数分别为0.194～0.300...     

Discharge report for the community pharmacist: Development and validation of a prototype

BackgroundThe potential benefit of community pharmacist's involvement in continuity of care is well-known. However, it is not standard practice to exchange information with the community pharmacist (CP) after hospitalization.ObjectiveTo construct and validate an evidence-based prototype of a discharge report for the community pharmacist.MethodsFirst, a review of literature, guidelines and established initiatives was performed to construct a preliminary discharge report. Secondly, the content of the discharge report was reviewed and optimized using semi-structured individual interviews with CPs and general practitioners (GPs).ResultsThe review identified six guidelines for information exchange with the CP originating from three countries, 17 research papers and three local initiatives. Overall, 49 different elements for a discharge document were identified. Based on recurring elements, a preliminary discharge report was created. Interviews with ten CPs and nine GPs provided insights into which information is considered crucial for patient safety and why. This allowed an optimization of the document. The final discharge report consists of three categories: administrative, medication and medical data. The medication data includes medication registered at hospital admission as well as at hospital discharge, drug indications, reasons for initiating, adjusting or discontinuing therapies and start/stop dates. The medical data contains reasons for hospitalization, comorbidities and allergies.ConclusionsThe literature review and semi-structured interviews resulted in an evidence-based prototype of a discharge report for the community pharmacist. This document contains both administrative, medical and medication data.     

Development of skill scale for communication skill measurement of pharmacist

To purpose of this study was to develop a pharmacist communication skill scale. A 38 items scale was made and 283 pharmacists responded. The original questionnaire consisted of 38 items, with 1-5 graded Likert scale. Completed responses of 228 pharmacists data were used for testing the reliability and the validity of this scale. The first group of items from the original questionnaire were 38, and finally 38 original items were chosen for investigation of content validity, correlation coefficient and commonality. From factor analysis, four factors were chosen among the 31 items as follows: patient respect reception skill, problem discovery and solution skill, positive approach skill, feelings processing skill. The correlation coefficient between this original scale and the KiSS-18 (Social Skill) received high score (r=0.694). The reliability of this scale showed high internal consistency (Cronbach α coefficient=0.951), so the result of test for the validity of this scale supports high content validity. Thus we propose adoption of pharmacist communication skill scale to carry a brief eponymous name as TePSS-31. The above findings indicate that this developed scale possess adequate validity and reliability for practical use.     

Asthma patients' satisfaction with the frequency and content of pharmacist counseling.

OBJECTIVE: To assess the level of expectation and satisfaction of patients with asthma regarding the counseling provided by community pharmacists, and to identify the counseling information patients consider important in helping them manage their asthma. DESIGN: Mailed survey. PARTICIPANTS: 208 patients seen in the University of Utah Asthma Clinic for at least 3 months, age 18 years or older, and on at least 1 asthma medication. MAIN OUTCOME MEASURES: Frequency of pharmacist-provided asthma medication counseling, patients' perception of the importance of counseling, and their satisfaction with counseling. RESULTS: Response rate was 55% (106 of 194 surveys returned). The majority of patients (> 90%) indicated that their community pharmacist "never" or "sometimes" discussed the management of their asthma with them. Frequency of counseling in three predefined areas of asthma education (role of medications, inhaler technique, and prevention of asthma attacks) was 1.91, 1.72, and 1.31, respectively (1 = never, 4 = always). Most patients (76%) considered these areas of counseling to be important for the management of their asthma. Most patients (62%) were "somewhat" to "pretty" satisfied with the type and amount of asthma counseling provided by their pharmacist. Counseling sessions averaged less than 3 minutes. Only 25% of patients would be willing to pay an additional amount for pharmaceutical care. CONCLUSION: Self-reported rates of patient counseling concerning asthma medications in the community pharmacy setting are low and adequately address neither the educational needs of patients nor the recommendations of the National Asthma Education and Prevention Program.     

Development and validation of the cigarette smoking consequences looming scale

IntroductionExperimental manipulations intended to alter cognitive appraisals of smoking-related threats may affect cigarette smoking and motivation to quit. However, no previous measure has directly assessed perceptions of smoking-related threats as increasing and coming closer in space and/or time (i.e., “looming”). The current research develops such a measure of dynamic smoking-related threat appraisal: the Cigarette Smoking Consequences Looming Scale (CSCLS).MethodsIn Study 1 (N = 124 daily smokers), the researchers created an initial, scenario-based version of the CSCLS and refined the measure based on factor analysis. In Study 2, 143 daily smokers completed a condensed CSCLS organized around two factors (Physical and Social consequence of smoking). In each study, participants also completed measures of dispositional looming perception, motivation to quit smoking, and smoking outcome expectancies.ResultsThe CSCLS showed strong internal consistency and concurrent validity in that scores on the measure correlated as expected in both studies with a general tendency to perceive threats as looming, outcome expectancies for smoking, and motivation to quit smoking.ConclusionsMeasuring perceptions of smoking-related consequences as looming may provide greater insight into the cognitive factors associated with motivation to quit smoking, which in turn may inform communications about the risks of smoking.     

Development and validation of a Spanish language patient satisfaction questionnaire with drug dispensing

Objective: To develop and validate a specific questionnaire about patient satisfaction with drug dispensing at Spanish community pharmacies. Method: A self-administered semi-structured questionnaire was designed centered on the perception of the patients with the dispensing service. To validate this questionnaire, it was administered at Spanish community pharmacies, which voluntarily agreed to participate in the study for a period of 2 months (March and April 2006). Patients or caregivers who were able to read and write were included in the study. Main outcome measure: Scores of the items related to satisfaction with the dispensing service. Results: The questionnaire consisted of: an introduction, 10 closed questions in an interval scale of five points, an open section to express comments, and finally demographic data of the patients. Twenty-seven community pharmacies participated in the validation, and 561 questionnaires were obtained with a response percentage of 56.5%. A Cronbach’s α coefficient of 0.91 was obtained. The Kaiser–Meyer–Olkin coefficient was 0.92, and the extraction of the principal components revealed a unique component explaining 55.2% of the total variance. About 15.5% of patients made additional comments that praised the quality of attention received and other aspects of the service such as the amiability and friendliness shown by pharmacy staff. Conclusion: The questionnaire developed shows evidence of validity and reliability for evaluating patient satisfaction with the dispensing service in community Pharmacies in Spain.     

Development and validation of the alcohol-related God locus of control scale

Control beliefs and spirituality appear to be important factors in recovery from alcoholism. However, the integration of these two constructs has received little attention, and the relationship of spiritually related control beliefs to recovery remains unclear. Currently no measures exist to specifically assess these beliefs. To address this need, the Alcohol-Related God Locus of Control scale (AGLOC) was developed. This 12-item self-report measure assesses perceptions of God/Higher Power's role in recovery from alcoholism. The AGLOC was administered to 144 recovering alcoholics attending Alcoholics Anonymous meetings. Exploratory factor analysis yielded a two-factor solution with one factor related to attributions of God control over initial cessation of drinking (Cessation) and the other factor related to attributions of God control over one's continued maintenance of sobriety (Maintenance). Both subscales and the overall scale demonstrated adequate to high internal consistency. Demonstrating convergent and discriminant validity, the total AGLOC scale and the Cessation subscale were significantly but moderately correlated with spirituality (both frequency and importance), and independent of perceptions of internal control over drinking. Maintenance subscale scores were inversely associated with internal drinking-related scores and were not associated with spiritual importance or frequency of spiritual practice. Findings support the utility of this instrument for the assessment of alcohol-related God/Higher Power locus of control beliefs in an alcoholic population and suggest the importance of further research on changes in alcohol-related God control beliefs throughout the course of recovery.     

Development and validation of patient-community pharmacist encounter toolkit regarding substance misuse: Delphi procedure

BackgroundPharmacists’ roles and services for patients with substance use are not well defined and inconsistent from site to site. Several barriers have been identified that hinder pharmacists’ care for people who use substances, such as a lack of training and resources. Clinical practice tools can aid in transferring evidence-based approaches to the practice sphere.ObjectivesThe aim of the study was to develop a substance misuse management toolkit for community pharmacists to help them manage their encounters with people who use substances.MethodsA focused literature review was conducted and 2 needs assessment studies, one for community pharmacists and one for patients informed the development of the toolkit. The toolkit is an adaption of the screening, brief intervention, and referral to treatment (SBIRT) approach, which is one of the most well-defined and effective strategies for substance use management. However, SBIRT is a novel care model in community pharmacy settings. Therefore, a substance misuse management toolkit with 20 items was created for community pharmacists incorporating evidence-based strategies and clinical algorithms. Delphi procedure was used to validate the toolkit.ResultsTwo rounds of questions were sent to experts in the field of substance misuse, some of whom were pharmacists. In both rounds, these experts were asked to rate the appropriateness and clarity of items in the toolkit and provide comments and suggestions. Items with a median rating of 7 or more out of 10 were included in the toolkit. In the second round, the experts were asked to rerate the revised version and provide additional feedback. After the second round, agreement was reached for almost all items of the toolkit.ConclusionA Delphi procedure was successfully used to provide evidence of the validity of the new guiding toolkit for community pharmacists. The toolkit will be implemented and evaluated to provide additional evidence of validity in practice.     

Development and validation of a scale measuring attitudes toward non-drinkers

The idea that individuals drink alcohol to fit in with their peers has been investigated by many researchers. However, the related concept that consumption of alcohol may serve as a means of avoiding the social costs associated with being a non-drinker has received little attention. Three studies (N = 94, 148, 236) are outlined, which detail the construction and preliminary validation of the Regan Attitudes toward Non-Drinkers Scale (RANDS). Results indicated that scale score reliability for the RANDS was good (α values range from .82 to .89) with exploratory and confirmatory factor analyses suggesting that the scale possesses a unidimensional factor structure. Importantly, scores on the RANDS emerged as a stronger predictor of self-reported yearly alcohol consumption and binge-drinking than indicants commonly assessed in alcohol use and abuse research in adolescents and young adults (e.g., peer pressure). Limitations of these studies and directions for future research are outlined.     

Development and validation of a disease-specific treatment satisfaction questionnaire for gastro-oesophageal reflux disease

BACKGROUND: Currently, no disease-specific, patient-based, treatment satisfaction instruments related to gastro-oesophageal reflux disease exist. AIM: To develop and validate a treatment satisfaction questionnaire for gastro-oesophageal reflux disease (TSQ-G). METHODS: A new questionnaire was developed from patient focus groups, clinician input and literature review. A validation study was conducted in treated gastro-oesophageal reflux disease patients. Ancillary measures included the Medical Outcomes Study Short Form-36, Quality of Life in Reflux and Dyspepsia, Gastrointestinal Symptom Rating Scale, Socially Desirable Response Scale, Patient Satisfaction Questionnaire-18 and physician and patient measures of symptoms and satisfaction. Statistical analyses included exploratory factor analysis, Cronbach's alpha, intra-class correlations, analyses of variance and t-tests. RESULTS: A total of 198 gastro-oesophageal reflux disease patients participated in the study, with a mean age of 50.7 years, 68% female and 84% Caucasian. The physician-rated severity of gastro-oesophageal reflux disease was mild (32%), moderate (50%) and severe (18%); 83% were on proton pump inhibitors. The final TSQ-G consisted of 28 items with seven sub-scales; Cronbach's alpha ranged from 0.58 to 0.94. Correlations with the expected sub-scales of the ancillary measures were moderate to strong. The TSQ-G sub-scales discriminated significantly between levels of physician-rated disease severity, symptom days and patient and physician ratings of satisfaction. CONCLUSIONS: The TSQ-G has excellent reliability and construct validity and appears to be a useful tool for the evaluation of treatment satisfaction in gastro-oesophageal reflux disease patients.     

Development and validation of a scale for assessing reasons for substance use in schizophrenia: The ReSUS scale

This paper reports on the development of a questionnaire to assess self reported reasons for substance use in schizophrenia: the ‘reasons for substance use in schizophrenia’ (ReSUS) scale and explores the relationship between reasons for use, psychiatric symptoms and substance use in a sample of 230 people with psychosis. Principal components analysis revealed three subscales: “coping with distressing emotions and symptoms', “social enhancement and intoxication” and “individual enhancement”. Predicted associations were partially supported. ‘Coping’ reasons for use were related to positive symptoms, general symptoms, global functioning, depression and suicide behaviour as well as substance use (quantity of use and problems related to use). ‘Individual enhancement’ reasons were related to positive symptoms, to global functioning and to negative consequences of substance use. ‘Social enhancement and intoxication’ reasons were related to negative consequences of use but not to psychopathology. The findings suggest that the ReSUS is a reliable and valid instrument which can be used to explore self reported reasons for substance use and their relationship to psychotic symptoms in people with schizophrenia and other psychotic disorders.     

Prevalence and satisfaction of discharged patients who recall interacting with a pharmacist during a hospital stay

Background:

To enhance the quality of patient care, the former Calgary Health Region (now part of Alberta Health Services) works continuously to improve pharmacy clinical services and to plan and implement new programs and services. Patient satisfaction is an important indicator of patients’ perception of the value of services provided.

Objectives:

To determine the baseline prevalence of patients admitted to the former Calgary Health Region with complex and high-risk medication needs who recalled speaking to a pharmacist during their hospital stay and their reported satisfaction with those interactions.

Methods:

A retrospective cross-sectional study was conducted by means of a telephone survey of patients shortly after discharge. Patients were asked whether they recalled speaking with a pharmacist during their last stay in the hospital. Patients who recalled such interactions were asked to rate pharmacy services on a 5-point scale.

Results:

Of 1200 patients who were discharged from hospital in June 2007 and who were contacted by telephone 2 months later, 400 patients agreed to participate in the survey; 3 of these patients were subsequently excluded. Of the 397 respondents included in the analysis, 83 (20.9%) recalled speaking to a pharmacist. Most of these rated the interaction favourably, with an average satisfaction rating of 4.4 out of 5.

Conclusions:

The Pharmacy Department of the former Calgary Health Region now has baseline frequency and satisfaction data for this indicator of service value, which can be used as comparators for future assessments of service value.     

Reliability testing and validation of the drug attitude scale

This study was designed to provide reliability testing and validity information of the Drug Attitude Scale (DAS). One hundred twenty-eight subjects were drawn from a residential substance abuse(1) treatment program within a community mental health center. Seventy-five percent of the subjects were males and 25% were females. Age ranged from 18 to 58 years. For the entire sample, coefficient alpha was found to be 0.87. Reliability estimates for the two subscales were also found to be quite similar. Clinical construct validity utilizing factor analysis strongly support the two-dimensional nature of the DAS and the accuracy of the instrument's scoring key. Initial testing of the DAS suggests that the scale represent a useful addition to the area of substance user assessment and rehabilitation.     

Psychometric validation of the depression and family functioning scale

Objective A new patient-reported outcome (PRO) measure developed to assess the impact of major depressive disorder (MDD) on partner and family interactions and quality of relationships, the Depression and Family Functioning Scale (DFFS), was analyzed to establish its reliability, validity, and responsiveness.

Methods Data from a multi-center, prospective, 2-year observational study were analyzed to assess the psychometric properties of the DFFS in patients with MDD (n_Baseline?=?478; n_Month2?=?433). Measures administered to assess validity included the Sheehan Disability Scale (SDS), Arizona Sexual Experiences Scale (ASEX) and Short Form Health Survey–12 (SF-12). Reliability (Cronbach’s alphas and intra-class correlations), construct validity (factor analysis and correlations), discriminating ability (analyses of variance), and responsiveness (standardized effect size estimates) were evaluated.

Results Principal components analyses indicated a single underlying dimension, confirmed by highly satisfactory Cronbach’s alphas (α_Baseline?=?0.85, α_Month2?=?0.89). The DFFS demonstrated satisfactory test–re-test reliability in patients with the same SDS family life/home responsibilities ratings at baseline and month 2 (intraclass correlation?=?0.75). Correlations with other measures showed convergent and divergent validity; e.g., the DFFS correlated better with SF-12 mental component scores (r_Baseline?=??0.35, r_Month2?=??0.49) than with SF-12 physical component scores (r_Baseline?=??0.05, r_Month2?=??0.31). Hypothesis tests were generally as predicted; many were statistically significant, substantiating DFFS discriminating ability. Standardized effect size estimates of responsiveness ranged from 0.44–0.84, demonstrating that the items were capable of detecting change.

Conclusions The psychometric analyses support the reliability, validity, and responsiveness of the DFFS and its usefulness for assessing the impact of depression on family functioning. The DFFS can potentially provide important information not captured in clinical practice and facilitate more comprehensive evaluation of MDD treatments.