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[急诊与急性医学中的实证卫生服务研究:患者招募与样本质量同步监测的初步结果]

[Empirical health services research in emergency and acute medicine : Preliminary results of concomitant monitoring of patient recruitment and sample quality].

作者信息

Krobisch V, Deutschbein J, Möckel M, Schmiedhofer M, Schneider A, Inhoff T, Keil T, Heintze C, Rose M, Müller-Werdan U, Schenk L

机构信息

Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland.

Notfall- und Akutmedizin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland.

出版信息

Med Klin Intensivmed Notfmed. 2020 Mar;115(2):125-133. doi: 10.1007/s00063-018-0522-y. Epub 2019 Jan 2.

Abstract

BACKGROUND

Up until now, research data on the implementation of empirical health services research in emergency departments in Germany are scarce.

STUDY AIM

A monitoring instrument applied in a multicenter prospective cohort study in emergency departments (EDs) is described and discussed regarding requirements for the control and supervision of data collection.

MATERIALS AND METHODS

Patients with cardiac diseases, respiratory tract infections, and hip fractures were recruited in eight EDs located in a central district of Berlin. Enrolment figures and nonresponder reasons were analyzed through descriptive statistics. Potential sample bias was examined in terms of response rates as well as the distribution of age and sex in the group of participants and nonresponders. Qualitative content analysis was applied to data from routine supervisory and feedback meetings with study nurses.

RESULTS

Within the first 8 months of data collection, 61.1% of the aimed 1104 patients were recruited. Most frequently stated nonresponder reasons were the dense work and care processes in EDs (41.9%) and patients' disease burden (24.7%). Moreover, qualitative results revealed problems with identifying potentially eligible participants and difficulties because of missing research infrastructure in study centers. The response rate of 50.7% and approximately equal distribution of age and sex in participants and nonresponders do not indicate sample biases.

DISCUSSION

The monitoring instrument has proven to be suited for empirical research in EDs and revealed optimization potential. We recommend using qualitative and quantitative data systematically.

摘要

背景

到目前为止,关于德国急诊科开展实证卫生服务研究的研究数据很少。

研究目的

描述并讨论一种在急诊科多中心前瞻性队列研究中应用的监测工具,涉及数据收集的控制和监督要求。

材料与方法

在柏林市中心区的8个急诊科招募患有心脏病、呼吸道感染和髋部骨折的患者。通过描述性统计分析入组人数和未响应者的原因。从响应率以及参与者和未响应者群体的年龄和性别分布方面检查潜在的样本偏差。对与研究护士的常规监督和反馈会议的数据进行定性内容分析。

结果

在数据收集的前8个月内,招募了目标1104名患者中的61.1%。最常提到的未响应者原因是急诊科繁忙的工作和护理流程(41.9%)以及患者的疾病负担(24.7%)。此外,定性结果揭示了识别潜在合格参与者的问题以及由于研究中心缺乏研究基础设施而带来的困难。50.7%的响应率以及参与者和未响应者年龄和性别的大致均等分布并未表明存在样本偏差。

讨论

该监测工具已被证明适用于急诊科的实证研究,并显示出优化潜力。我们建议系统地使用定性和定量数据。

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