Webbe James, Brunton Ginny, Ali Shohaib, Longford Nicholas, Modi Neena, Gale Chris
Neonatal Medicine, Imperial College London, London, UK.
UCL Institute of Education, London, UK.
BMJ Paediatr Open. 2018 Oct 9;2(1):e000343. doi: 10.1136/bmjpo-2018-000343. eCollection 2018.
Multiple outcomes can be measured in infants that receive neonatal care. It is unknown whether outcomes of importance to parents and patients differ from those of health professionals. Our objective was to systematically map neonatal care outcomes discussed in qualitative research by patients, parents and healthcare professionals and test whether the frequency with which outcomes are discussed differs between groups.
Systematic review of qualitative literature. The following databases were searched: Medline, CINAHL, EMBASE, PsycINFO and ASSIA from 1997 to 2017. Publications describing qualitative data relating to neonatal care outcomes, reported by former patients, parents or healthcare professionals, were included. Narrative text was analysed and outcomes grouped thematically by organ system. Permutation testing was applied to assess an association between the outcomes identified and stakeholder group.
Sixty-two papers containing the views of over 4100 stakeholders were identified; 146 discrete outcomes were discussed; 58 outcomes related to organ systems and 88 to other more global domains. Permutation testing provides evidence that parents, former patients and health professionals reported outcomes with different frequencies (p=0.037).
Parents, patients and health professionals focus on different outcomes when discussing their experience of neonatal care. A wide range of neonatal care outcomes are reported in qualitative research; many are global outcomes relating to the overall status of the infant. The views of former patients and parents should be taken into consideration when designing research; the development of a core outcomes set for neonatal research will facilitate this.
接受新生儿护理的婴儿可测量多种结果。对父母和患者而言重要的结果是否与卫生专业人员所关注的不同尚不清楚。我们的目的是系统梳理患者、父母和卫生专业人员在定性研究中讨论的新生儿护理结果，并检验不同群体讨论这些结果的频率是否存在差异。
定性文献的系统评价。检索了以下数据库：1997年至2017年的医学文献数据库（Medline）、护理学与健康领域数据库（CINAHL）、荷兰医学文摘数据库（EMBASE）、心理学文摘数据库（PsycINFO）和亚洲社会科学索引数据库（ASSIA）。纳入了由 former患者、父母或卫生专业人员报告的描述与新生儿护理结果相关定性数据的出版物。对叙述性文本进行分析，并按器官系统对结果进行主题分组。应用置换检验来评估所确定的结果与利益相关者群体之间的关联。
确定了62篇包含4100多名利益相关者观点的论文；讨论了146个离散结果；58个结果与器官系统相关，88个结果与其他更广泛的领域相关。置换检验提供了证据表明父母、former患者和卫生专业人员报告结果的频率不同（p=0.037）。
父母、患者和卫生专业人员在讨论他们的新生儿护理经历时关注不同的结果。定性研究报告了广泛的新生儿护理结果；许多是与婴儿总体状况相关的广泛结果。在设计研究时应考虑former患者和父母的观点；制定新生儿研究的核心结局集将有助于此。
