Berghaus D, Schütz A, Hammer U, Gaser E, Wedding U, Meißner W
Klinik für Innere Medizin II, Abteilung Palliativmedizin, Universitätsklinikum Jena, Erlanger Allee 101, 07747, Jena, Deutschland.
Tumorzentrum, HELIOS-Klinikum Erfurt, Nordhäuser Straße 74, 99089, Erfurt, Deutschland.
Schmerz. 2019 Jun;33(3):236-243. doi: 10.1007/s00482-019-0363-5.
Structure and process parameters are not sufficient for adequate quality assurance in specialized palliative home care (SAPV). Asking the patients and their relatives for their assessment is crucial. A focus group in Jena, Germany, developed the quality assurance in specialized palliative home care (QUAPS) questionnaire for this assessment of outcome parameters, which was tested in two studies.
The aim of the study was to evaluate the feasibility of a questionnaire for patients, relatives and SAPV teams.
The questionnaire collects outcome parameters on a Likert scale as well as the distress of respondents using the numeric rating scale (NRS). In the pilot study, QUAPS I was tested in three SAPV teams. The survey was simplified in the follow-up study, QUAPS II, where 17 teams were included. Both studies were conducted with an ex-post-facto design.
In QUAPS I, complete datasets could be obtained for 43 out of 308 surveyed cases. In QUAPS II, 169 complete datasets resulted from 371 surveyed cases. The SAPV staff assessed the QUAPS II survey as being organizationally feasible. The questionnaire shows good internal consistency and high approval for the surveyed aspects of SAPV care. Ceiling effects occurred. More than 70% of respondents reported a distress score >5.
The simplified survey in QUAPS II resulted in a higher rate of complete datasets. The detected ceiling effects restrict the conclusions of the survey. Biases like social desirability cannot be ruled out. In the future, a combination of different questionnaires (e. g. integrated palliative outcome score [IPOS] and QUAPS) should be explored.
在专科姑息家庭护理（SAPV）中，结构和过程参数不足以确保充分的质量保证。询问患者及其亲属的评估意见至关重要。德国耶拿的一个焦点小组开发了专科姑息家庭护理质量保证（QUAPS）问卷，用于评估结果参数，并在两项研究中进行了测试。
本研究的目的是评估一份针对患者、亲属和SAPV团队的问卷的可行性。
该问卷采用李克特量表收集结果参数，并使用数字评定量表（NRS）收集受访者的痛苦程度。在试点研究中，QUAPS I在三个SAPV团队中进行了测试。在后续研究QUAPS II中对调查进行了简化，该研究纳入了17个团队。两项研究均采用事后设计。
在QUAPS I中，308例调查病例中有43例可获得完整数据集。在QUAPS II中，371例调查病例产生了169个完整数据集。SAPV工作人员认为QUAPS II调查在组织上是可行的。该问卷显示出良好的内部一致性，并且对SAPV护理的调查方面认可度较高。出现了天花板效应。超过70%的受访者报告痛苦得分>5。
QUAPS II中的简化调查产生了更高比例的完整数据集。检测到的天花板效应限制了调查结论。无法排除社会期许性等偏差。未来，应探索不同问卷（如综合姑息结局评分[IPOS]和QUAPS）的组合。
