Department of Gastroenterology, South Tyneside and Sunderland NHS Foundation Trust, South Shields, UK
Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
BMJ Open Gastroenterol. 2021 Oct;8(1). doi: 10.1136/bmjgast-2021-000653.
Measuring patient experience of gastrointestinal (GI) procedures is a key component of evaluation of quality of care. Current measures of patient experience within GI endoscopy are largely clinician derived and measured; however, these do not fully represent the experiences of patients themselves. It is important to measure the entirety of experience and not just experience directly during the procedure. We aimed to develop a patient-reported experience measure (PREM) for GI procedures.
Phase 1: semi-structured interviews were conducted in patients who had recently undergone GI endoscopy or CT colonography (CTC) (included as a comparator). Thematic analysis identified the aspects of experience important to patients. Phase 2: a question bank was developed from phase 1 findings, and iteratively refined through rounds of cognitive interviews with patients who had undergone GI procedures, resulting in a pilot PREM. Phase 3: patients who had attended for GI endoscopy or CTC were invited to complete the PREM. Psychometric properties were investigated. Phase 4 involved item reduction and refinement.
Phase 1: interviews with 35 patients identified six overarching themes: anxiety, expectations, information & communication, embarrassment & dignity, choice & control and comfort. Phase 2: cognitive interviews refined questionnaire items and response options. Phase 3: the PREM was distributed to 1650 patients with 799 completing (48%). Psychometric properties were found to be robust. Phase 4: final questionnaire refined including 54 questions assessing patient experience across five temporal procedural stages.
This manuscript gives an overview of the development and validation of the Newcastle ENDOPREM™, which assesses all aspects of the GI procedure experience from the patient perspective. It may be used to measure patient experience in clinical care and, in research, to compare patients' experiences of different endoscopic interventions.
测量患者对胃肠道(GI)程序的体验是评估护理质量的关键组成部分。目前,GI 内镜检查中患者体验的测量主要是由临床医生得出并测量的;然而,这些并不能完全代表患者自身的体验。重要的是要衡量整个体验,而不仅仅是在手术过程中直接体验。我们旨在开发一种用于 GI 程序的患者报告体验测量(PREM)。
第 1 阶段:对最近接受过 GI 内镜检查或 CT 结肠成像(CTC)的患者(包括作为比较器)进行半结构式访谈。主题分析确定了对患者重要的体验方面。第 2 阶段:从第 1 阶段的发现中开发了一个问题库,并通过对接受过 GI 程序的患者进行几轮认知访谈进行迭代完善,得出了一个试点 PREM。第 3 阶段:邀请接受过 GI 内镜检查或 CTC 的患者完成 PREM。调查了心理测量特性。第 4 阶段涉及项目减少和改进。
第 1 阶段:对 35 名患者的访谈确定了六个总体主题:焦虑、期望、信息和沟通、尴尬和尊严、选择和控制以及舒适度。第 2 阶段:认知访谈完善了问卷项目和响应选项。第 3 阶段:向 1650 名患者分发 PREM,其中 799 名完成(48%)。发现心理测量特性稳健。第 4 阶段:最终问卷完善,包括 54 个问题,评估患者在五个时间程序阶段的体验。
本文概述了纽卡斯尔 ENDOPREM™的开发和验证,该工具从患者角度评估 GI 程序体验的所有方面。它可用于衡量临床护理中的患者体验,并在研究中比较不同内镜干预措施的患者体验。