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溃疡性结肠炎的医疗质量:一种改良的德尔菲专家小组方法。

Quality of Care in Ulcerative Colitis: A Modified Delphi Panel Approach.

作者信息

Peyrin-Biroulet Laurent, Baumgart Daniel C, Armuzzi Alessandro, Gionchetti Paolo, Sebastian Shaji, Danese Silvio, Magro Fernando, Higgins Sophie, Yaworksy Andrew, Banderas Benjamin, Kachroo Sumesh

机构信息

Department Gastroenterology, CHU de Nancy, Vandoeuvre-lès-Nancy, France.

Department of Gastroenterology and Hepatology, Inflammatory Bowel Disease Center, Charité Medical Center, Virchow Hospital, Medical School of the Humboldt-University of Berlin, Berlin, Germany.

出版信息

Dig Dis. 2018;36(5):346-353. doi: 10.1159/000489845. Epub 2018 Jul 3.

Abstract

OBJECTIVES

To establish clinical consensus on important and relevant quality-of-care (QoC) attributes in ulcerative colitis (UC) treatment that may improve treatment outcomes and guide best practices.

METHODS

Thirty-eight QoC attributes were identified in a literature review. Sixteen European-based experts were selected based on their contributions to UC guidelines, publications, and patient care. A 3-round, modified Delphi panel was conducted including an interview round, and 2 web-based rounds to reach consensus and finalize a QoC attribute list.

RESULTS

The draft QoC attribute list derived from a literature review and Round 1, expert interviews, comprised 63 attributes. In Rounds 2 and 3, the QoC attributes frequently rated as critically important were diagnosis (n = 15, 93.8%), treatment adherence (n = 15, 93.8%), and access to care/treatment (Round 2: n = 14, 87.5%; Round 3: n = 15, 93.8%). The final QoC attribute list consisted of 61 attributes across 20 domains, with the most attributes reported in the "treatment goals" domain (n = 9).

CONCLUSION

QoC is a complex and evolving concept that can improve outcomes while maximizing healthcare resources. Limited time and resources hamper clinicians' ability to openly and empathetically communicate with patients; novel technology may help to offer solutions.

摘要

目的

就溃疡性结肠炎(UC)治疗中重要且相关的护理质量(QoC)属性达成临床共识,这些属性可能改善治疗效果并指导最佳实践。

方法

通过文献综述确定了38个QoC属性。基于他们对UC指南、出版物和患者护理的贡献,挑选了16位欧洲专家。进行了三轮改进的德尔菲小组讨论,包括一轮访谈和两轮基于网络的讨论,以达成共识并确定QoC属性列表。

结果

从文献综述和第一轮专家访谈得出的QoC属性草案列表包含63个属性。在第二轮和第三轮中,经常被评为至关重要的QoC属性是诊断(n = 15,93.8%)、治疗依从性(n = 15,93.8%)以及获得护理/治疗的机会(第二轮:n = 14,87.5%;第三轮:n = 15,93.8%)。最终的QoC属性列表由20个领域的61个属性组成,其中“治疗目标”领域报告的属性最多(n = 9)。

结论

QoC是一个复杂且不断发展的概念,它可以在最大限度利用医疗资源的同时改善治疗效果。有限的时间和资源阻碍了临床医生与患者进行开放且共情沟通的能力;新技术可能有助于提供解决方案。

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