Tory Heather O, Carrasco Ruy, Griffin Thomas, Huber Adam M, Kahn Philip, Robinson Angela Byun, Zurakowski David, Kim Susan
Pediatric Rheumatology, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT, 06106, USA.
Department of Pediatrics, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, 06032, CT, USA.
Pediatr Rheumatol Online J. 2018 Apr 19;16(1):28. doi: 10.1186/s12969-018-0248-7.
A standardized set of quality measures for juvenile idiopathic inflammatory myopathies (JIIM) is not in use. Discordance has been shown between the importance ascribed to quality measures between patients and families and physicians. The objective of this study was to assess and compare the importance of various aspects of high quality care to patients with JIIM and their families with healthcare providers, to aid in future development of comprehensive quality measures.
Surveys were developed by members of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Juvenile Dermatomyositis Workgroup through a consensus process and administered to patients and families through the CureJM Foundation and to healthcare professionals through CARRA. The survey asked respondents to rate the importance of 19 items related to aspects of high quality care, using a Likert scale.
Patients and families gave generally higher scores for importance to most of the quality measurement themes compared with healthcare professionals, with ratings of 13 of the 19 measures reaching statistical significance (p < 0.05). Of particular importance, however, was consensus between the groups on the top five most important items: quality of life, timely diagnosis, access to rheumatology, normalization of functioning/strength, and ability for self care.
Despite overall differences in the rating of importance of quality indicators between patients and families and healthcare professionals, the groups agreed on the most important aspects of care. Recognizing areas of particular importance to patients and families, and overlapping in importance with providers, will promote the development of standardized quality measures with the greatest potential for improving care and outcomes for children with JIIM.
目前尚未使用一套针对青少年特发性炎性肌病(JIIM)的标准化质量指标。患者及家属与医生对质量指标重要性的认识存在差异。本研究的目的是评估并比较高质量护理的各个方面对JIIM患者及其家属与医疗服务提供者的重要性,以助力未来全面质量指标的制定。
儿童关节炎和风湿病研究联盟(CARRA)青少年皮肌炎工作组的成员通过共识过程制定了调查问卷,通过CureJM基金会向患者及家属发放,并通过CARRA向医疗专业人员发放。该调查问卷要求受访者使用李克特量表对与高质量护理方面相关的19个项目的重要性进行评分。
与医疗专业人员相比,患者及家属对大多数质量测量主题的重要性评分普遍更高,19项测量中有13项的评分具有统计学意义(p < 0.05)。然而,特别重要的是,两组在最重要的五个项目上达成了共识:生活质量、及时诊断、获得风湿病治疗、功能/力量正常化以及自我护理能力。
尽管患者及家属与医疗专业人员在质量指标重要性评分上存在总体差异,但两组在护理的最重要方面达成了一致。认识到对患者及家属特别重要且与提供者在重要性上重叠的领域,将促进标准化质量指标的制定,这对于改善JIIM患儿的护理和结局具有最大潜力。