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在实施基于网络的荷兰重症监护随访诊所分诊工具期间吸取的经验教训。

Lessons learnt during the implementation of a web-based triage tool for Dutch intensive care follow-up clinics.

机构信息

Academic Medical Center, Department of Medical Informatics, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.

National Intensive Care Evaluation (NICE) foundation, Amsterdam, The Netherlands.

出版信息

BMJ Open. 2018 Sep 24;8(9):e021249. doi: 10.1136/bmjopen-2017-021249.


DOI:10.1136/bmjopen-2017-021249
PMID:30249628
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6157570/
Abstract

OBJECTIVES: Screening for symptoms of postintensive care syndrome is based on a long list of questionnaires, filled out by the intensive care unit (ICU) survivor and manually reviewed by the health professional. This is an inefficient and time-consuming process. The aim of this study was to evaluate the feasibility of a web-based triage tool and to compare the outcomes from web-based questionnaires to those from paper-based questionnaires. DESIGN: A mixed-methods study. SETTING: Nine Dutch ICU follow-up clinics. PARTICIPANTS: 221 ICU survivors and 14 health professionals. INTERVENTIONS: A web-based triage tool was implemented by nine ICU follow-up clinics. End users, that is, health professionals were interviewed in order to evaluate the feasibility of the triage tool. ICU survivors were invited to fill out web-based questionnaires 3 months after hospital discharge. PRIMARY OUTCOMES: Outcomes of the questionnaires were merged with clinical data from a national quality registry to assess the differences in outcomes between paper-based and web-based questionnaires. RESULTS: 221 ICU survivors received an invitation to fill out questionnaires, 93 (42.1%) survivors did not respond to the invitation. Respondents to the web-based questionnaires (n=54) were significantly younger and had a significantly longer ICU stay than those who preferred the paper-based questionnaires (n=74). The prevalence of mental, physical and nutritional problems was high, although comparable between the groups. Health professionals' interviews revealed that the software was complex to use (n=8) and although emailing survivors is very convenient, not all survivors have an email address (n=7). CONCLUSIONS: Web-based screening software has major benefits compared with paper-based screening. However, implementation has shown to be rather difficult and there are important barriers to consider. Although different in age, the health status is comparable between the users of the web-based questionnaire and paper-based questionnaire.

摘要

目的:对 ICU 后综合征症状进行筛查的依据是一长串问卷,由 ICU 幸存者填写,并由卫生专业人员手动审查。这是一个效率低下且耗时的过程。本研究的目的是评估基于网络的分诊工具的可行性,并比较基于网络的问卷和基于纸质的问卷的结果。

设计:混合方法研究。

设置:9 个荷兰 ICU 随访诊所。

参与者:221 名 ICU 幸存者和 14 名卫生专业人员。

干预措施:9 个 ICU 随访诊所实施了基于网络的分诊工具。最终用户,即卫生专业人员接受了访谈,以评估分诊工具的可行性。ICU 幸存者在出院后 3 个月被邀请填写基于网络的问卷。

主要结果:将问卷的结果与国家质量登记处的临床数据合并,以评估纸质问卷和基于网络的问卷的结果差异。

结果:221 名 ICU 幸存者收到了填写问卷的邀请,93 名(42.1%)幸存者未回复邀请。选择填写基于网络问卷的幸存者(n=54)明显比选择纸质问卷的幸存者(n=74)年轻,且 ICU 住院时间更长。精神、身体和营养问题的患病率很高,尽管两组之间的患病率相当。卫生专业人员的访谈显示,该软件使用复杂(n=8),尽管向幸存者发送电子邮件非常方便,但并非所有幸存者都有电子邮件地址(n=7)。

结论:与纸质筛查相比,基于网络的筛查软件具有重大优势。然而,实施起来相当困难,需要考虑一些重要的障碍。尽管年龄不同,但基于网络问卷和纸质问卷使用者的健康状况相当。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5957/6157570/e2fb79c7218c/bmjopen-2017-021249f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5957/6157570/e2fb79c7218c/bmjopen-2017-021249f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5957/6157570/e2fb79c7218c/bmjopen-2017-021249f01.jpg

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引用本文的文献

[1]
Factors to consider when designing post-hospital interventions to support critical illness recovery: Systematic review and qualitative evidence synthesis.

J Intensive Care Soc. 2025-1-3

[2]
Patients suffering from psychological impairments following critical illness are in need of information.

J Intensive Care. 2020-1-9

[3]
Dutch ICU survivors have more consultations with general practitioners before and after ICU admission compared to a matched control group from the general population.

PLoS One. 2019-5-23

本文引用的文献

[1]
Usability Testing of an Electronic Patient-Reported Outcome System for Survivors of Critical Illness.

Am J Crit Care. 2016-7

[2]
Data Resource Profile: the Dutch National Intensive Care Evaluation (NICE) Registry of Admissions to Adult Intensive Care Units.

Int J Epidemiol. 2015-12

[3]
Capturing Patient-Reported Outcome (PRO) Data Electronically: The Past, Present, and Promise of ePRO Measurement in Clinical Trials.

Patient. 2015-8

[4]
Recommendations for intensive care follow-up clinics; report from a survey and conference of Dutch intensive cares.

Minerva Anestesiol. 2015-2

[5]
Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study.

Nurs Health Sci. 2013-3-11

[6]
Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders' conference.

Crit Care Med. 2012-2

[7]
A comparison of a postal survey and mixed-mode survey using a questionnaire on patients' experiences with breast care.

J Med Internet Res. 2011-9-27

[8]
Health-related quality of life and physical recovery after a critical illness: a multi-centre randomised controlled trial of a home-based physical rehabilitation program.

Crit Care. 2011-6-9

[9]
Web-based questionnaires: the future in epidemiology?

Am J Epidemiol. 2010-9-29

[10]
Quality of life after intensive care: a systematic review of the literature.

Crit Care Med. 2010-12

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