Sawyer Susan M, Ambresin Anne-Emmanuelle, Bennett Kristina E, Patton George C
Royal Children's Hospital Centre for Adolescent Health, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia.
Royal Children's Hospital Centre for Adolescent Health, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia.
J Adolesc Health. 2014 Oct;55(4):484-90. doi: 10.1016/j.jadohealth.2014.01.023. Epub 2014 Mar 31.
Despite growing interest in measurement of health care quality and patient experience, the current evidence base largely derives from adult health settings, at least in part because of the absence of appropriately developed measurement tools for adolescents. To rectify this, we set out to develop a conceptual framework and a set of indicators to measure the quality of health care delivered to adolescents in hospital.
A conceptual framework was developed from the following four elements: (1) a review of the evidence around what young people perceive as "adolescent-friendly" health care; (2) an exploration with adolescent patients of the principles of patient-centered care; (3) a scoping review to identify core clinical practices around working with adolescents; and (4) a scoping review of existing conceptual frameworks. Using criteria for indicator development, we then developed a set of indicators that mapped to this framework.
Embedded within the notion of patient- and family-centered care, the conceptual framework for adolescent-friendly health care (quality health care for adolescents) was based on the constructs of experience of care (positive engagement with health care) and evidence-informed care. A set of 14 indicators was developed, half of which related to adolescents' and parents' experience of care and half of which related to aspects of evidence-informed care.
The conceptual framework and indicators of quality health care for adolescents set the stage to develop measures to populate these indicators, the next step in the agenda of improving the quality of health care delivered to adolescents in hospital settings.
尽管对医疗质量和患者体验测量的兴趣日益浓厚，但目前的证据基础主要来自成人健康环境，至少部分原因是缺乏专门为青少年开发的测量工具。为纠正这一情况，我们着手制定一个概念框架和一套指标，以衡量医院为青少年提供的医疗服务质量。
从以下四个要素构建了一个概念框架：（1）对年轻人所认为的“青少年友好型”医疗服务相关证据进行回顾；（2）与青少年患者探讨以患者为中心的护理原则；（3）进行范围审查以确定围绕青少年工作的核心临床实践；（4）对现有概念框架进行范围审查。然后，我们根据指标制定标准，开发了一套与该框架相对应的指标。
以患者和家庭为中心的护理理念为基础，青少年友好型医疗服务（青少年优质医疗服务）的概念框架基于护理体验（与医疗服务的积极互动）和循证护理的构建。共制定了14项指标，其中一半与青少年及其父母的护理体验相关，另一半与循证护理的各个方面相关。
青少年优质医疗服务的概念框架和指标为开发填充这些指标的测量方法奠定了基础，这是提高医院为青少年提供的医疗服务质量议程的下一步。
