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专业人员运用患者报告结局测量信息以提高医疗质量的经验:一项定性研究的系统评价

The experiences of professionals with using information from patient-reported outcome measures to improve the quality of healthcare: a systematic review of qualitative research.

作者信息

Boyce Maria B, Browne John P, Greenhalgh Joanne

机构信息

Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.

School of Sociology and Social Policy, University of Leeds, Leeds, UK.

出版信息

BMJ Qual Saf. 2014 Jun;23(6):508-18. doi: 10.1136/bmjqs-2013-002524. Epub 2014 Feb 6.

Abstract

OBJECTIVES

To synthesise qualitative studies that investigated the experiences of healthcare professionals with using information from patient-reported outcome measures (PROMs) to improve the quality of care.

DESIGN

A qualitative systematic review was conducted by searching PubMed, PsycINFO and CINAHL with no time restrictions. Hand searching was also performed. Eligible studies were evaluated using the Critical Appraisal Skills Programme toolkit for qualitative studies. A thematic synthesis identified common themes across studies. Study characteristics were examined to explain differences in findings.

SETTING

All healthcare settings.

PARTICIPANTS

Healthcare professionals.

OUTCOMES

Professionals' views of PROMs after receiving PROMs feedback about individual patients or groups of patients.

RESULTS

Sixteen studies met the inclusion criteria. Barriers and facilitators to the use of PROMs emerged within four main themes: collecting and incorporating the data (practical), valuing the data (attitudinal), making sense of the data (methodological) and using the data to make changes to patient care (impact).

CONCLUSIONS

Professionals value PROMs when they are useful for the clinical decision-making process. Practical barriers to the routine use of PROMs are prominent when the correct infrastructure is not in place before commencing data collection and when their use is disruptive to normal work routines. Technology can play a greater role in processing the information in the most efficient manner. Improvements to the interpretability of PROMs should increase their use. Attitudes to the use of PROMs may be improved by engaging professionals in the planning stage of the intervention and by ensuring a high level of transparency around the rationale for data collection.

摘要

目的

综合定性研究,这些研究调查了医疗保健专业人员利用患者报告结局测量(PROMs)信息以提高护理质量的经历。

设计

通过检索PubMed、PsycINFO和CINAHL进行无时间限制的定性系统评价。还进行了手工检索。使用定性研究的批判性评估技能计划工具包对符合条件的研究进行评估。主题综合确定了各项研究中的共同主题。检查研究特征以解释结果差异。

背景

所有医疗保健环境。

参与者

医疗保健专业人员。

结局

专业人员在收到关于个体患者或患者群体的PROMs反馈后对PROMs的看法。

结果

16项研究符合纳入标准。PROMs使用的障碍和促进因素出现在四个主要主题中:收集和纳入数据(实践方面)、重视数据(态度方面)、理解数据(方法方面)以及利用数据对患者护理做出改变(影响方面)。

结论

当PROMs对临床决策过程有用时,专业人员重视它们。在开始数据收集之前没有适当的基础设施以及其使用干扰正常工作流程时,PROMs常规使用的实际障碍很突出。技术可以在以最有效的方式处理信息方面发挥更大作用。提高PROMs的可解释性应会增加其使用。通过让专业人员参与干预的规划阶段并确保数据收集理由的高度透明度,可以改善对PROMs使用的态度。

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