Development and validation of the RQC: a daily contact log for ACT and ICM teams.

Epidemiologia e psichiatria sociale Pub Date : 2010-01-01
Alain D Lesage, Daniel Gélinas, Jocelyn Bisson, Eric Dion, Nicole Ricard
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Abstract

Aim: Instruments to measure the process--the daily activities of home care workers--have received little attention and may impede research in refining the active ingredients, the clientele best served and continuous quality improvement. We developed a decade ago in Quebec, Canada, a new daily contact log (relevé quotidien des contacts or RQC) that has now reached in practice 1 million entries.

Methods: Three features distinguish the RQC development, namely, practical ergonomics, a clear logic, and response categories easy to understand and retain. The instrument is filled following any 10-minute or more contact with or about the client, and covers the location, time and actors of the episode of care, and the nature of the intervention (crisis, representing, accompanying, discussing) in 10 areas (i.e. medication, daily living activities, housing, relationships, substance abuse, legal, etc.). Inter-rater agreement for each RQC response category and rater agreement with a criterion measure (coded vignettes) were evaluated.

Results: Kappa coefficients and intra-class correlation coefficients yielded results ranging from at least moderate to generally substantial agreement for all 77 response categories.

Conclusions: The new RQC may support international studies of the implementation and application of various forms of intensive home care, refining its indications, and serves as a clinical and managerial tool to ensure quality of the interventions.

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RQC的开发和验证:ACT和ICM团队的每日联系日志。
目的:测量过程的仪器-家庭护理人员的日常活动-很少受到关注,可能会阻碍研究提炼有效成分,为客户提供最好的服务和持续的质量改进。十年前,我们在加拿大魁北克省开发了一个新的每日联系人日志(relevant quotidien des contacts或RQC),目前已达到100万条记录。方法:区分RQC发展的三个特点,即实用的工效学、清晰的逻辑、易于理解和记忆的响应类别。在与来访者接触10分钟或更长时间后填写该表格,内容包括发生护理事件的地点、时间和参与者,以及干预的性质(危机、代表、陪伴、讨论),涉及10个领域(即药物治疗、日常生活活动、住房、关系、药物滥用、法律等)。评估每个RQC反应类别的评分者之间的一致性以及评分者与标准测量(编码小片段)的一致性。结果:Kappa系数和类内相关系数产生的结果在所有77个反应类别中从至少中等到基本一致。结论:新的RQC可以支持各种形式的家庭重症监护实施和应用的国际研究,完善其适应症,并作为临床和管理工具,以确保干预措施的质量。
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