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通过患者报告体验指标评估以患者为中心程度(ASPIRED):一项混合方法研究的方案

Assessment of patient centredness through patient-reported experience measures (ASPIRED): protocol of a mixed-methods study.

作者信息

Christalle Eva, Zeh Stefan, Hahlweg Pola, Kriston Levente, Härter Martin, Scholl Isabelle

机构信息

Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

出版信息

BMJ Open. 2018 Oct 21;8(10):e025896. doi: 10.1136/bmjopen-2018-025896.

Abstract

INTRODUCTION

The impact of patient centredness (PC) in healthcare has grown over the years. However, conceptualisations of PC are heterogeneous. Existing patient-reported measures of PC have shown inconsistencies and shortcomings. This impedes the comparison of results across studies. To foster PC, it is important to know which dimensions matter most to patients and to be able to measure its current extent from the patients' perspective. This study aims (1) to assess relevance of dimensions of PC from the patients' perspective, (2) to develop and psychometrically test a core set of patient-reported experience measures (PREMs) assessing PC and (3) to investigate the feasibility of implementation of this core set in routine healthcare.

METHODS AND ANALYSIS

A mixed-methods approach will be used. In phase 1, 200 patients will assess the relevance of the dimensions of PC in a Delphi study using a plain language description. In phase 2, the core set of PREMs will be developed through literature reviews, focus groups, key informant interviews and content validity ratings. The core set will be tested psychometrically in a cross-sectional study with 2000 inpatient and outpatients with different chronic conditions (ie, cancer, cardiovascular diseases, mental disorders and musculoskeletal disorders). In phase 3, the feasibility of implementation of the core set will be assessed through semistructured interviews with healthcare practitioners after piloting in routine care. Furthermore, an expert workshop will be held on how to foster implementation.

ETHICS AND DISSEMINATION

The study will be carried out in accordance to the latest version of the Helsinki Declaration of the World Medical Association and principles of good scientific practice. The study was approved by the Ethics Committee of the Medical Association Hamburg, Germany (study ID: PV5724). The study results will be disseminated in scientific journals and through collaboration partners and plain language press releases.

摘要

引言

多年来,以患者为中心(PC)在医疗保健中的影响不断扩大。然而,对PC的概念化是多种多样的。现有的患者报告的PC测量方法存在不一致性和缺陷。这阻碍了不同研究结果的比较。为了促进PC,了解哪些维度对患者最重要并能够从患者角度衡量其当前程度非常重要。本研究旨在:(1)从患者角度评估PC维度的相关性;(2)开发并对评估PC的一组核心患者报告体验测量指标(PREMs)进行心理测量测试;(3)调查在常规医疗保健中实施这组核心指标的可行性。

方法与分析

将采用混合方法。在第一阶段,200名患者将在德尔菲研究中使用通俗易懂的描述评估PC维度的相关性。在第二阶段,将通过文献综述、焦点小组、关键信息提供者访谈和内容效度评级来开发PREMs的核心指标集。将在一项横断面研究中对2000名患有不同慢性病(即癌症、心血管疾病、精神障碍和肌肉骨骼疾病)的住院和门诊患者进行核心指标集的心理测量测试。在第三阶段,在常规护理中进行试点后,将通过与医疗保健从业者的半结构化访谈评估核心指标集的实施可行性。此外,还将举办一次关于如何促进实施的专家研讨会。

伦理与传播

本研究将按照世界医学协会最新版《赫尔辛基宣言》和良好科学实践原则进行。该研究已获得德国汉堡医学协会伦理委员会批准(研究编号:PV5724)。研究结果将在科学期刊上发表,并通过合作伙伴和通俗易懂的新闻稿进行传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/86ba/6196960/1a9859ba2692/bmjopen-2018-025896f01.jpg

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