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在智力/发育障碍青少年中采用患者报告结局测量:情境影响和实践模式。

Adoption of patient-reported outcome measures with youth with intellectual/developmental disabilities: Contextual influences and practice patterns.

作者信息

Greenberg Kimberly K, Schwartz Ariel E, Kramer Jessica M

机构信息

Department of Occupational Therapy, Boston University, Boston, Massachusetts, USA.

Department of Occupational Therapy, University of Florida, Gainesville, Florida, USA.

出版信息

Child Care Health Dev. 2021 Jul;47(4):501-508. doi: 10.1111/cch.12862. Epub 2021 Mar 8.

Abstract

BACKGROUND

The purpose of this study was to identify potential barriers to patient reported outcome measure (PROM) adoption with youth and young adults with intellectual and/or developmental disabilities (IDD) and to understand current PROM adoption patterns of paediatric practitioners working with this population.

METHODS

We used a web-based survey to collect data from paediatric practitioners who work with youth with IDD about factors influencing the adoption of PROMs and the frequency of PROM use across age groups (elementary, middle school and high school/transition age) and practice settings (school and rehabilitation).

RESULTS

A total of 113 paediatric practitioners (occupational therapist = 48, physical therapist = 32, physician = 16, other = 17) responded to the survey with an average of 15 years of experience working with youth ages 8-21 with IDD. Accessibility and appropriateness, psychometric evidence, and time were most frequently ranked among the top three factors that influence practitioners' adoption of PROMs. Practitioners reported 'never or rarely' using PROMs 39%-65% of the time across age groups.

CONCLUSIONS

Our results suggest that paediatric practitioners may be infrequently using PROMs with youth with IDD because of perceived inaccessibility and time requirements of PROMs and practice-environment barriers, including access to evidence and caseload demands. Because PROMs can facilitate client-centred care, addressing these potential barriers to adoption may improve paediatric rehabilitation.

摘要

背景

本研究的目的是确定智力和/或发育障碍(IDD)的青少年和青年采用患者报告结局测量(PROM)的潜在障碍,并了解与该人群合作的儿科从业者目前的PROM采用模式。

方法

我们使用基于网络的调查,从与IDD青少年合作的儿科从业者那里收集数据,了解影响PROM采用的因素以及不同年龄组(小学、初中和高中/过渡年龄)和实践环境(学校和康复机构)中PROM的使用频率。

结果

共有113名儿科从业者(职业治疗师=48名,物理治疗师=32名,医生=16名,其他=17名)回复了调查,他们平均有15年与8至21岁IDD青少年合作的经验。可及性和适用性、心理测量学证据以及时间最常被列为影响从业者采用PROM的三大因素。从业者报告在各年龄组中,39%-65%的时间“从不或很少”使用PROM。

结论

我们的结果表明,儿科从业者可能很少对IDD青少年使用PROM,原因是认为PROM难以获取、时间要求高以及实践环境障碍,包括获取证据的机会和工作量需求。由于PROM可以促进以客户为中心的护理,解决这些潜在的采用障碍可能会改善儿科康复。

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