衡量精神卫生保健的患者体验：对患者报告体验指标的系统与批判性综述
Measuring the Patient Experience of Mental Health Care: A Systematic and Critical Review of Patient-Reported Experience Measures.
作者信息
Fernandes Sara, Fond Guillaume, Zendjidjian Xavier Yves, Baumstarck Karine, Lançon Christophe, Berna Fabrice, Schurhoff Franck, Aouizerate Bruno, Henry Chantal, Etain Bruno, Samalin Ludovic, Leboyer Marion, Llorca Pierre-Michel, Coldefy Magali, Auquier Pascal, Boyer Laurent
机构信息
Aix-Marseille University, School of Medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, Marseille, France.
FondaMental Foundation, Créteil, France.
出版信息
Patient Prefer Adherence. 2020 Nov 3;14:2147-2161. doi: 10.2147/PPA.S255264. eCollection 2020.
BACKGROUND
There is growing concern about measuring patient experience with mental health care. There are currently numerous patient-reported experience measures (PREMs) available for mental health care, but there is little guidance for selecting the most suitable instruments. The objective of this systematic review was to provide an overview of the psychometric properties and the content of available PREMs.
METHODS
A comprehensive review following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines was conducted using the MEDLINE database with no date restrictions. The content of PREMs was analyzed using an inductive qualitative approach, and the methodological quality was assessed according to Pesudovs quality criteria.
RESULTS
A total of 86 articles examining 75 PREMs and totaling 1932 items were included. Only four PREMs used statistical methods from item response theory (IRT). The 1932 items covered seven key mental health care domains: interpersonal relationships (22.6%), followed by respect and dignity (19.3%), access and care coordination (14.9%), drug therapy (14.1%), information (9.6%), psychological care (6.8%) and care environment (6.1%). Additionally, a few items focused on patient satisfaction (6.7%) rather than patient experience. No instrument covered the latent trait continuum of patient experience, as defined by the inductive qualitative approach, and the psychometric properties of the instruments were heterogeneous.
CONCLUSION
This work is a critical step in the creation of an item library to measure mental health care patient-reported experience that will be used in France to develop, validate, and standardize item banks and computerized adaptive testing (CAT) based on IRT. It will also provide internationally replicable measures that will allow direct comparisons of mental health care systems.
TRIAL REGISTRATION
NCT02491866.
背景
人们越来越关注衡量患者对精神卫生保健的体验。目前有许多用于精神卫生保健的患者报告体验测量工具（PREMs），但在选择最合适的工具方面几乎没有指导。本系统评价的目的是概述现有PREMs的心理测量特性和内容。
方法
按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行全面综述，使用无日期限制的MEDLINE数据库。采用归纳定性方法分析PREMs的内容，并根据佩苏多夫斯质量标准评估方法学质量。
结果
共纳入86篇文章，研究了75种PREMs，共计1932个项目。只有四种PREMs使用了项目反应理论（IRT）的统计方法。1932个项目涵盖了七个关键的精神卫生保健领域：人际关系（22.6%），其次是尊重和尊严（19.3%）、获得服务和护理协调（14.9%）、药物治疗（14.1%）、信息（9.6%）、心理护理（6.8%）和护理环境（6.1%）。此外，少数项目关注患者满意度（6.7%）而非患者体验。没有一种工具涵盖归纳定性方法所定义的患者体验的潜在特质连续体，且这些工具的心理测量特性存在异质性。
结论
这项工作是创建一个用于测量精神卫生保健患者报告体验的项目库的关键一步，该项目库将在法国用于开发、验证和标准化基于IRT的题库和计算机自适应测试（CAT）。它还将提供国际上可复制的测量方法，以便对精神卫生保健系统进行直接比较。
试验注册
NCT02491866。
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