Salido-Vallejo R, González-Velasco M, Guilabert M, García E I, Mira J J
Hospital Reina Sofía de Córdoba, Córdoba, España.
Vocalía de Dermofarmacia del Colegio Oficial de Farmacéuticos de Sevilla, Sevilla, España.
J Healthc Qual Res. 2018 Nov-Dec;33(6):360-369. doi: 10.1016/j.jhqr.2018.09.005. Epub 2018 Nov 27.
To analyse barriers limiting an integral approach in the care process of patients with actinic keratosis, and to validate a questionnaire of their perception in order to assess this approach.
A qualitative study (Focus Group) was conducted to assess the perception of the healthcare process of professionals (dermatologists, family doctors, nurses, pharmacists and managers), and patients. A validation study of a new tool was conducted, defining the scope and contents of a questionnaire of perceived quality. Reliability, consistency and validity were analysed after inviting a convenience sample of 225 patients to respond.
Underdiagnosis in primary care, a higher variability in resources, and access to the health care circuit, together with gaps in patient information about actinic keratosis, are relevant barriers to achieve comprehensive care in this disease condition. The result of the focus groups advised to elaborate 14 reactive items. A total of 224 patients responded (mean age 71.6, SD 11.1), of which 153 (68%) were men. Two factors were isolated including 12 items (explained variance of 58%). The consistency of this factorial solution was .87, the split-half reliability being .76, with the scores in the factors showing an adequate predictive capacity.
The coordination between levels and to reduce to variability in equipment and clinical decision making in Primary Care are the most prominent barriers. The questionnaire has appropriate metric properties and it explores the information and care by the medical staff and the information and advice provided by the pharmacist.
分析限制光化性角化病患者护理过程中采用综合方法的障碍，并验证一份关于他们认知的问卷，以评估这种方法。
进行了一项定性研究（焦点小组），以评估专业人员（皮肤科医生、家庭医生、护士、药剂师和管理人员）以及患者对医疗过程的认知。对一种新工具进行了验证研究，确定了一份感知质量问卷的范围和内容。在邀请225名方便样本患者进行回答后，分析了可靠性、一致性和有效性。
初级保健中的诊断不足、资源的较大差异以及进入医疗保健流程的机会，再加上患者关于光化性角化病的信息存在差距，是在这种疾病情况下实现全面护理的相关障碍。焦点小组的结果建议拟定14个反应性项目。共有224名患者做出回应（平均年龄71.6岁，标准差11.1），其中153名（68%）为男性。分离出两个因素，包括12个项目（解释方差为58%）。这个因子解的一致性为0.87，分半信度为0.76，各因素得分显示出足够的预测能力。
各级之间的协调以及减少初级保健中设备和临床决策的差异是最突出的障碍。该问卷具有适当的度量特性，它探讨了医务人员提供的信息和护理以及药剂师提供的信息和建议。
