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镰状细胞病患者报告的体验测量。

Patient-reported experience measure in sickle cell disease.

机构信息

Paediatric Haematology, King's College Hospital NHS Foundation Trust, London, UK.

Imperial College London, London, UK.

出版信息

Arch Dis Child. 2018 Dec;103(12):1104-1109. doi: 10.1136/archdischild-2018-314955. Epub 2018 Aug 4.

Abstract

OBJECTIVES

To develop patient-reported experience measure surveys for patients with sickle cell disease (SCD) to understand their healthcare and lived experience in the UK and for their use in future to inform healthcare service development.

DESIGN

Picker methodology was used as follows: (1) qualitative scoping by focus group discussions; (2) questionnaire development through stakeholder consultations; (3) construct validation of questionnaires through cognitive testing; and (4) further assessment of construct validity by a nationwide pilot survey.

SETTING

Patients with SCD and their carers were eligible. Focus group discussions took place in non-hospital settings, arranged out of hours. Cognitive testing took place in specialist sickle cell clinics. The pilot survey was available to UK participants only and was administered through web-based questionnaires, face-to face completion and in sickle cell community events.

PARTICIPANTS

Thirty-three patients and carers took part in the focus groups, 21 participants undertook cognitive testing and 722 respondents completed the pilot survey.

RESULTS

Findings highlighted a widespread prevalence of poor knowledge about SCD among healthcare providers and the public. Poorer experience of care was present in the emergency setting compared with planned care, of which lack of timely provision of pain relief was of concern. Adolescents and young people reported significantly poorer experience of care in several domains compared with children or adults.

CONCLUSIONS

The new surveys functioned well, with good evidence of validity, and were accessible to the SCD patient population, supporting their future use in assessing patient experience to inform service delivery and improvements in care quality.

摘要

目的

开发用于镰状细胞病 (SCD) 患者的患者报告体验测量调查,以了解他们在英国的医疗保健和生活体验,并在未来用于为医疗保健服务的发展提供信息。

设计

采用 Picker 方法如下:(1)通过焦点小组讨论进行定性范围界定;(2)通过利益相关者协商制定问卷;(3)通过认知测试对问卷进行结构验证;(4)通过全国性试点调查进一步评估结构有效性。

设置

符合条件的是 SCD 患者及其照顾者。焦点小组讨论在非医院环境中进行,安排在工作时间之外。认知测试在专门的镰状细胞诊所进行。试点调查仅对英国参与者开放,并通过基于网络的问卷、面对面完成和镰状细胞社区活动进行管理。

参与者

33 名患者及其照顾者参加了焦点小组,21 名参与者进行了认知测试,722 名受访者完成了试点调查。

结果

研究结果突出表明,医疗保健提供者和公众普遍缺乏对 SCD 的了解。与计划性护理相比,急诊护理的体验较差,其中缺乏及时提供疼痛缓解措施令人担忧。与儿童或成人相比,青少年和年轻人在几个领域报告的护理体验明显较差。

结论

新调查功能良好,具有良好的有效性证据,并且可供 SCD 患者群体使用,支持未来用于评估患者体验,为服务提供和改善护理质量提供信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/456e/6287562/59c1c8fc3fca/archdischild-2018-314955f01.jpg

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