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患者报告的结局与言语病理学中的循证实践。

Patient-Reported Outcomes and Evidence-Based Practice in Speech-Language Pathology.

机构信息

Department of Communication Sciences and Disorders and Center for Health Assessment Research and Translation, University of Delaware, Newark.

Geriatric Research, Education, and Clinical Center, VA Health Care System, and Department of Communication Sciences and Disorders, University of Pittsburgh, PA.

出版信息

Am J Speech Lang Pathol. 2020 Feb 7;29(1):357-370. doi: 10.1044/2019_AJSLP-19-00076. Epub 2020 Feb 3.

Abstract

Purpose The patient's perspective of their health is a core component of evidence-based practice (EBP) and person-centered care. Patient-reported outcomes (PROs), captured with PRO measures (PROMs), are the main way of formally soliciting and measuring the patient's perspective. Currently, however, PROs play a relatively small role in mainstream speech-language pathology practice. The purpose of this article is to raise important questions about how PROs could be applied to EBP in speech-language pathology for individuals with communication disorders and to propose preliminary approaches to address some of these questions. Method Based on a narrative review of the literature, this article introduces relevant terminology and broadly describes PRO applications in other health care fields. The article also raises questions related to PRO-informed clinical practice in speech-language pathology. To address some of these questions, the article explores previous research to provide suggestions for clinical administration, interpretation, and future research. Conclusion More routine measurement of subjective health constructs via PROMs-for example, constructs such as effort, participation, self-efficacy, and psychosocial functioning-may improve EBP. More routine use of PROMs could significantly expand the information that is available to clinicians about individual clients and add to the evidence base for the profession of speech-language pathology. However, careful consideration and more research are needed on how to capture and interpret PROs from individuals with cognitive and language disorders.

摘要

目的 患者对自身健康的看法是循证实践(EBP)和以患者为中心的护理的核心组成部分。患者报告的结果(PROs),通过患者报告的结果测量(PROMs)来获取,是正式征求和衡量患者观点的主要方式。然而,目前 PROs 在主流言语病理学实践中的作用相对较小。本文旨在提出一些关于如何将 PROs 应用于言语病理学中存在沟通障碍的个体的 EBP 的重要问题,并提出初步方法来解决其中的一些问题。

方法 基于文献的叙述性回顾,本文介绍了相关术语,并广泛描述了 PRO 在其他医疗保健领域的应用。本文还提出了与 PRO 知情的言语病理学临床实践相关的问题。为了解决其中的一些问题,本文探讨了先前的研究,为临床管理、解释和未来研究提供了建议。

结论 通过 PROMs 更常规地测量主观健康结构,例如努力、参与、自我效能和心理社会功能等结构,可能会改善 EBP。更常规地使用 PROMs 可以显著增加临床医生对个体客户的可用信息,并为言语病理学专业增加证据基础。然而,需要仔细考虑并进行更多研究,以了解如何从认知和语言障碍患者中获取和解释 PROs。

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