患者确定的结肠镜检查服务质量指标。
Patient-identified quality indicators for colonoscopy services.
作者信息
Sewitch Maida J, Dubé Catherine, Brien Stephanie, Jiang Mengzhu, Hilsden Robert J, Barkun Alan N, Armstrong David
机构信息
Department of Medicine, McGill University, Montreal, Quebec.
出版信息
Can J Gastroenterol. 2013 Jan;27(1):25-32. doi: 10.1155/2013/574956.
BACKGROUND
Current quality improvement tools for endoscopy services, such as the Global Rating Scale (GRS), emphasize the need for patient-centred care. However, there are no studies that have investigated patient expectations and/or perceptions of quality indicators in endoscopy services.
OBJECTIVES
To identify quality indicators for colonoscopy services from the patient perspective; to rate indicators of importance; to determine factors that influence indicator ratings; and to compare the identified indicators with those of the GRS.
METHODS
A two-phase mixed methods study was undertaken in Montreal (Quebec), Calgary (Alberta) and Hamilton (Ontario) among patients ≥18 years of age who spoke and read English or French. In phase 1, focus group participants identified quality indicators that were then used to construct a survey questionnaire. In phase 2, survey questionnaires, which were completed immediately after colonoscopy, prompted respondents to rate the 20 focus group-derived indicators according to their level of importance (low, medium, high) and to list up to nine additional items. Multiple logistic regression analysis was used to determine the factors that influenced focus group-derived indicator ratings. Patient-identified indicators were compared with those used in the GRS to identify novel indicators.
RESULTS
Three quality indicator themes were identified by 66 participants in 12 focus groups: communication, comfort and service environment. Of the 828 surveys distributed, 402 (48.6%) were returned and 65% of focus group-derived indicators were rated highly important by at least 55% of survey respondents. Indicator ratings differed according to age, sex, site and perceived colorectal cancer risk. Of the 29 patient-identified indicators, 17 (58.6%) were novel.
CONCLUSIONS
Patients identified 17 novel quality indicators, suggesting that patients and health professionals differ in their perspectives with respect to quality in colonoscopy services.
背景
当前用于内镜检查服务的质量改进工具，如全球评级量表（GRS），强调以患者为中心的护理的必要性。然而，尚无研究调查患者对内镜检查服务质量指标的期望和/或认知。
目的
从患者角度确定结肠镜检查服务的质量指标；对指标的重要性进行评级；确定影响指标评级的因素；并将确定的指标与GRS的指标进行比较。
方法
在蒙特利尔（魁北克）、卡尔加里（艾伯塔）和汉密尔顿（安大略）对年龄≥18岁、会说和读英语或法语的患者进行了一项两阶段混合方法研究。在第1阶段，焦点小组参与者确定质量指标，然后用于构建调查问卷。在第2阶段，结肠镜检查后立即完成的调查问卷促使受访者根据重要程度（低、中、高）对20个焦点小组得出的指标进行评级，并列出多达九个其他项目。采用多因素逻辑回归分析确定影响焦点小组得出的指标评级的因素。将患者确定的指标与GRS中使用的指标进行比较，以确定新的指标。
结果
12个焦点小组的66名参与者确定了三个质量指标主题：沟通、舒适度和服务环境。在分发的828份调查问卷中，402份（48.6%）被收回，65%的焦点小组得出的指标被至少55%的调查受访者评为非常重要。指标评级因年龄、性别、地点和感知的结直肠癌风险而异。在29个患者确定的指标中，17个（58.6%）是新的。
结论
患者确定了17个新的质量指标，表明患者和卫生专业人员在结肠镜检查服务质量方面的观点存在差异。
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