家庭医生团队动力量表汉化及信效度检验

Background ?The family doctor team dynamics mainly refer to inter-member interaction state of the family doctor team in the process of providing services. Improving the team dynamics among family doctors can help promote the enhancement of team effectiveness. The Primary Care Team Dynamics ScalePCTDSdeveloped by Sara J. Singer's team at Harvard Universitywhich can be used to comprehensively assess the primary care team dynamics. Objective? To translate the PCTDS into a Chinese versionand test the reliability and validity of the Chinese version. Methods? The Brislin's model for translationback translation and cross-cultural adaptation was utilized to translate the PCTDS into a Chinese versionPCTDS-Cstrictly following the principle of scale introductionand the PCTDS-C was revised in accordance with an email-based expert consultation and a pre-test. Then a total of 569 family doctor team members were selected from 17 citiesincluding Guangdong's ShenzhenHubei's WuhanZhejiang's Hangzhouand so onby the convenience sampling method from November 2021 to February 2022 to attend a survey using a self-developed Demographic Questionnaire and the PCTDS-C. The critical ratioCRmethod and item-total correlation were used for item analysis. The content validity of the scale was assessed by the expert consultation. The structural validity of the scale was tested by the KMO testBartlett's test of sphericityexploratory factor analysisand confirmatory factor analysis. And the reliability of the scale was evaluated by the Cronbach's α. Results? Three hundred and nine of the 569 cases54.3%who returned responsive questionnaires were included for analysis. The absolute CR value for each of the entries was greater than 3.000P<0.001and the average r-value of the correlation between each item score and the total scale score was less than 0.300P<0.001. The I-CVI was 0.692-1.000and S-CVI was 0.896. A significant KMO value of 0.946 and a significant value of Bartlett's test of sphericityχ2=4 488.198df= 406P<0.001indicated that the scale was suitable for factor analysis. Four common factors with an eigenvalue greater than 1.000 were extractedincluding the conditions of team effectiveness4 itemsteam shared understanding6 itemsteam collaboration process9 itemsand team effectiveness9 itemsexplaining 74.2% of the total variance. The load value of each item on the common factor was 0.561-0.802. Confirmatory factor analysis indicated that the performance of fit indices of the initial model was not satisfactory. After the correlations between the error variables e20 and e31e6 and e7e19 and e31e24 and e25e18 and e23e4 and e10e3 and e9 were added according to the indicator promptsexcept for χ2/dfIFI and CFIthe performance of the other fit indices of the modified model was still unsatisfactoryχ2/df =2.313RMSEA=0.091GFI=0.748AGFI=0.699NFI=0.866IFI=0.919CFI=0.919. The Cronbach's α for the total scale was 0.978. And the Cronbach's α was 0.826 for the conditions of team effectiveness0.945 for team shared understanding0.957 for team collaboration processand 0.956 for team effectiveness. Conclusion? The PCTDS-C has proven to have a good reliability and a fair validitywhich can be used as a tool to evaluate the family doctor team dynamics in China. Howeverthere is still much room for the scale improvement. Future research can focus on in-depth exploration of the dimensions and item classification of the scaleand the adding of dimensions in line with the actual situation of family doctor teams in China.