Avedis Donabedian Research Institute (FAD), Barcelona, Spain.
Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
Health Expect. 2021 Oct;24(5):1626-1638. doi: 10.1111/hex.13303. Epub 2021 Jul 12.
The literature on self-management interventions (SMIs) is growing exponentially, but it is characterized by heterogeneous reporting that limits comparability across studies and interventions. Building an SMI taxonomy is the first step towards creating a common language for stakeholders to drive research in this area and promote patient self-management and empowerment.
To develop and validate the content of a comprehensive taxonomy of SMIs for long-term conditions that will help identify key characteristics and facilitate design, reporting and comparisons of SMIs.
We employed a mixed-methods approach incorporating a literature review, an iterative consultation process and mapping of key domains, concepts and elements to develop an initial SMI taxonomy that was subsequently reviewed in a two-round online Delphi survey with a purposive sample of international experts.
The final SMI taxonomy has 132 components classified into four domains: intervention characteristics, expected patient/caregiver self-management behaviours, outcomes for measuring SMIs and target population characteristics. The two-round Delphi exercise involving 27 international experts demonstrated overall high agreement with the proposed items, with a mean score (on a scale of 1-9) per component of 8.0 (range 6.1-8.8) in round 1 and 8.1 (range 7.0-8.9) in round 2.
The SMI taxonomy contributes to building a common framework for the patient self-management field and can help implement and improve patient empowerment and facilitate comparative effectiveness research of SMIs. Patient or public contribution. Patients' representatives contributed as experts in the Delphi process and as partners of the consortium.
自我管理干预(SMI)的文献呈指数级增长,但报告形式存在异质性,限制了研究和干预之间的可比性。建立 SMI 分类法是为利益相关者创建共同语言以推动该领域研究并促进患者自我管理和赋权的第一步。
制定和验证用于长期疾病的综合 SMI 分类法的内容,以帮助确定关键特征,并促进 SMI 的设计、报告和比较。
我们采用了一种混合方法,包括文献综述、迭代咨询过程以及关键领域、概念和要素的映射,以开发初步的 SMI 分类法,随后在两轮具有国际专家的在线 Delphi 调查中对其进行了审查。
最终的 SMI 分类法有 132 个组件,分为四个领域:干预特征、预期患者/照护者自我管理行为、衡量 SMI 的结果以及目标人群特征。涉及 27 名国际专家的两轮 Delphi 练习表明,专家对拟议项目总体上高度一致,每个组件的平均得分(在 1-9 的范围内)为第一轮的 8.0(范围 6.1-8.8),第二轮为 8.1(范围 7.0-8.9)。
SMI 分类法有助于为患者自我管理领域建立共同框架,并有助于实施和改善患者赋权,并促进 SMI 的比较效果研究。患者或公众的贡献。患者代表作为 Delphi 过程中的专家以及联盟的合作伙伴做出了贡献。