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中国公众视角卫生体系评价工具的开发及信效度验证

Development and validity testing of the Chinese Version People′s Voice Survey

  • 摘要:
    目的 开发兼具国际可比性和本土特征的中国公众视角卫生体系评价工具(PVS-CN),并检验其信效度。
    方法 在合作开发全球版评价工具的基础上经本土化修订、翻译—回译、跨文化调适和优化调整形成PVS-CN,并对其中的量表条目进行检验。于2023年10月在全国范围内(港澳台地区除外)随机抽取移动电话号码进行电话调查,共收集有效问卷534份,其中42人在间隔2周后进行了重测。通过项目分析、探索性因子分析和验证性因子分析及其他信效度检验方法验证量表信效度。
    结果 PVS-CN量表共27个条目,包含自评健康状况、最近就医体验、对公立医疗体系的评价、对卫生体系的整体评价和对卫生体系质量的期望5个维度,可解释总变异的67.663%;量表条目内容效度指数(I-CVI)为0.71~1.00,平均量表水平内容效度指数(S-CVI/Ave)为0.98,全体一致量表内容效度指数(S-CVI/UA)为0.85,内容效度良好;验证性因子分析表明,量表结构效度良好,χ2/df=2.131,规范拟合指数(NFI)=0.934,比较拟合指数(CFI)=0.964,拟合优度指数(GFI)=0.910,Tucker-Lewis 指数(TLI)=0.960,递增拟合指数(IFI)=0.964,近似误差均方根(RMSEA)=0.046;信度检验结果显示,总量表Cronbach's α系数为0.942,折半信度为0.849,重测信度为0.874,表明量表内部一致性及稳定性较好。
    结论 本研究开发的PVS-CN信效度良好,可作为从公众角度评估我国卫生体系的有效工具并可进一步推广应用。

     

    Abstract:
    Objective To develop the Chinese Version People′s Voice Survey (PVS-CN) that incorporates both international comparability and local characteristics and test its reliability and validity.
    Methods On the basis of collaborative development of the global version of the evaluation tool, the PVS-CN was formed through localization revisions, translation–back translation, cross-cultural adaptation, and adjustments, with the scale items being tested. In October 2023, a mobile phone survey was conducted across China′s mainland (excluding Hong Kong, Macao, and Taiwan), where mobile phone numbers were randomly selected. A total of 534 valid questionnaires were collected, with 42 participants undergoing retesting after a two-week interval. The reliability and validity of the scale were assessed by item analysis, exploratory factor analysis, confirmatory factor analysis, and other methods of reliability and validity testing.
    Results The PVS-CN scale consists of 27 items, covering five dimensions: self-assessed health status, recent healthcare experience, evaluation of the public healthcare system, overall evaluation of the health system, and expectations for the quality of the health system, explaining 67.663% of the total variance. The scale presents the item-level content validity index (I-CVI) ranging from 0.71 to 1.00, the scale-level content validity index/universal agreement (S-CVI/UA) of 0.85, and the average scale-level content validity index (S-CVI/Ave) of 0.98, demonstrating strong content validity. Confirmatory factor analysis shows that the structural validity of the scale is good, with χ2/df = 2.131, normed fit index (NFI) = 0.934, comparative fit index (CFI) = 0.964, goodness-of-fit index (GFI) = 0.910, Tucker-Lewis index (TLI) = 0.960, incremental fit index (IFI) = 0.964, and root mean square error of approximation (RMSEA) = 0.046. The reliability test results show that the overall scale has the Cronbach′s α coefficient of 0.942, the split-half reliability of 0.849, and the test-retest reliability of 0.874, indicating good internal consistency and stability of the scale.
    Conclusion The PVS-CN developed in this study demonstrates good reliability and validity, serving as an effective tool for assessing China′s healthcare system from the public perspective, with potential for further application.

     

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