Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Support Care Cancer. 2010 Jan;18(1):121-30. doi: 10.1007/s00520-009-0638-y. Epub 2009 Apr 23.
Assessment of current practice with a valid set of indicators is the key to successfully improving the quality of patient-centred care. For improvement purposes, we developed indicators of patient-centred cancer care and tested them on a population of patients with non-small cell lung cancer (NSCLC).
Recommendations for patient-centred care were extracted from clinical guidelines, and patients were interviewed to develop indicators for assessing the patient-centredness of cancer care. These indicators were tested with regard to psychometric characteristics (room for improvement, applicability, discriminating capacity and reliability) on 132 patients with NSCLC treated in six hospitals in the east Netherlands. Data were collected from patients by means of questionnaires.
Eight domains of patient-centred cancer care were extracted from 61 oncology guidelines and 37 patient interviews and were translated into 56 indicators. The practice test amongst patients with NSCLC showed the most room for improvement within the domains 'emotional and psychosocial support', 'physical support' and 'information supply'. Overall, 26 of the 56 indicators had good psychometric characteristics.
Developing a valid set of patient-centred indicators is a first step towards improving the patient centredness of cancer care. Indicators can be based on recommendations from guidelines, but adding patient opinions leads to a more complete picture of patient centredness. The practice test on patients with NSCLC showed that the patient centredness of cancer care can be improved. Our set of indicators may also be useful for future quality assessments for other patients with cancers or chronic diseases.
通过一套有效的指标来评估当前的实践情况，是成功提高以患者为中心的护理质量的关键。出于改进的目的，我们开发了以患者为中心的癌症护理指标，并在非小细胞肺癌（NSCLC）患者群体中对其进行了测试。
从临床指南中提取了以患者为中心的护理建议，并对患者进行了访谈，以制定评估癌症护理以患者为中心程度的指标。在荷兰东部的 6 家医院治疗的 132 名 NSCLC 患者中，针对这些指标的心理测量学特征（改进空间、适用性、区分能力和可靠性）进行了测试。通过问卷从患者那里收集数据。
从 61 份肿瘤学指南和 37 次患者访谈中提取了 8 个以患者为中心的癌症护理领域，并将其转化为 56 个指标。在 NSCLC 患者中进行的实践测试表明，在“情感和心理社会支持”、“身体支持”和“信息供应”等领域有最大的改进空间。总体而言，56 个指标中有 26 个具有良好的心理测量学特征。
开发一套有效的以患者为中心的指标是提高癌症护理以患者为中心程度的第一步。指标可以基于指南中的建议，但加入患者的意见可以更全面地了解以患者为中心的程度。在 NSCLC 患者中进行的实践测试表明，癌症护理的以患者为中心程度可以得到提高。我们的这套指标也可能对未来其他癌症或慢性病患者的质量评估有用。
