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囊性纤维化群体中以患者为中心的结局研究的教育需求与偏好:混合方法研究

Educational Needs and Preferences for Patient-Centered Outcomes Research in the Cystic Fibrosis Community: Mixed Methods Study.

作者信息

Godfrey Emily M, Kazmerski Traci M, Brown Georgia, Thayer Erin K, Mentch Laura, Pam Molly, Al Achkar Morhaf

机构信息

Department of Family Medicine, University of Washington School of Medicine, Seattle, WA, United States.

Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States.

出版信息

JMIR Form Res. 2021 Mar 4;5(3):e24302. doi: 10.2196/24302.

DOI:10.2196/24302
PMID:33661127
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7974760/
Abstract

BACKGROUND

Cystic fibrosis (CF) is a rare, life-shortening, multiorgan disease, the treatment of which has seen significant increases in the life expectancy of those with CF. Many advances in CF care are thanks to the dedicated and active participation of people with CF as research participants. Unfortunately, most CF research teams still do not fully partner with people with CF or their caregivers.

OBJECTIVE

The aim of this study was to determine the interest, knowledge gaps, and desired format for patient-centered outcomes research (PCOR) training in the CF community.

METHODS

We surveyed patients, caregivers, researchers, research staff, and diverse health care providers via list servers and social media outreach about their knowledge of, experience with, and preferences for PCOR training components. We followed the survey with 3 small-group discussion sessions with 22 participants who completed the survey to establish consensus and prioritize key learning components of a PCOR training program. We summarized results using descriptive statistics.

RESULTS

A total of 170 participants completed the survey (patients/caregivers: 96/170, 56.5%; researchers/health care providers: 74/170, 43.5%). Among providers, 26% (19/74) were physicians/advanced practice providers, 20% (15/74) were nurses, and 54% (40/74) were from other disciplines. Among all participants, 86.5% (147/170) expressed interest in learning about PCOR, although training topics and training format differed between the patient/caregiver and researcher/health care provider groups. Before participating in PCOR, patients/caregivers wanted to understand more about expectations of them as partners on PCOR research teams (82/96, 85%). Meanwhile, researchers/health care providers desired information on how to include outcomes important to patients/caregivers (55/74, 74%) and the quality and impact of PCOR research (52/74, 70% and 51/74, 69%, respectively). Patients/caregivers were most interested in learning about the time commitment as a PCOR team member (75/96, 78%). Researchers/health care providers wanted to receive training about how to establish trust (47/74, 64%) and maintain confidentiality (47/74, 64%) when including patient or caregiver partners on the PCOR team. During follow-up discussions, participants emphasized the importance of addressing the traditional patient/caregiver and researchers/health care provider hierarchy by teaching about transparency, appreciation, creating a common language between the groups, and providing specific training on "how" to do PCOR.

CONCLUSIONS

Our findings suggest CF community members are interested in PCOR. A high-quality training program would fill a current deficit in methodological research. This assessment identified the topics and formats desired and can be used to develop targeted training to enhance meaningful PCOR in CF.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8348/7974760/a0715d0d5dd8/formative_v5i3e24302_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8348/7974760/a0715d0d5dd8/formative_v5i3e24302_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8348/7974760/a0715d0d5dd8/formative_v5i3e24302_fig1.jpg
摘要

背景

囊性纤维化(CF)是一种罕见的、缩短寿命的多器官疾病,其治疗已使CF患者的预期寿命显著提高。CF护理方面的许多进展得益于CF患者作为研究参与者的专注和积极参与。不幸的是,大多数CF研究团队仍未与CF患者或其护理人员充分合作。

目的

本研究的目的是确定CF社区中以患者为中心的结局研究(PCOR)培训的兴趣、知识差距和期望形式。

方法

我们通过列表服务器和社交媒体宣传,对患者、护理人员、研究人员、研究工作人员和不同的医疗保健提供者进行了调查,了解他们对PCOR培训内容的了解、经验和偏好。在调查之后,我们与22名完成调查的参与者进行了3次小组讨论会议,以达成共识并确定PCOR培训计划的关键学习内容的优先级。我们使用描述性统计方法总结了结果。

结果

共有170名参与者完成了调查(患者/护理人员:96/170,56.5%;研究人员/医疗保健提供者:74/170,43.5%)。在提供者中,26%(19/74)是医生/高级执业提供者,20%(15/74)是护士,54%(40/74)来自其他学科。在所有参与者中,86.5%(147/170)表示有兴趣了解PCOR,尽管患者/护理人员组和研究人员/医疗保健提供者组的培训主题和培训形式有所不同。在参与PCOR之前,患者/护理人员希望更多地了解作为PCOR研究团队合作伙伴对他们的期望(82/96,85%)。同时,研究人员/医疗保健提供者希望获得有关如何纳入对患者/护理人员重要的结局的信息(55/74,74%)以及PCOR研究的质量和影响(分别为52/74,70%和51/74,69%)。患者/护理人员对了解作为PCOR团队成员的时间投入最感兴趣(75/96,78%)。研究人员/医疗保健提供者希望接受有关在PCOR团队中纳入患者或护理人员合作伙伴时如何建立信任(47/74,64%)和保持保密(47/74,64%)的培训。在后续讨论中,参与者强调了通过传授透明度、赞赏、在群体之间创造共同语言以及提供关于“如何”进行PCOR的具体培训来解决传统的患者/护理人员与研究人员/医疗保健提供者等级制度的重要性。

结论

我们的研究结果表明CF社区成员对PCOR感兴趣。一个高质量的培训计划将填补当前方法学研究的不足。这项评估确定了期望的主题和形式,可用于开展有针对性的培训,以加强CF中有意义的PCOR。

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