From the Departments of Pediatrics.
Internal Medicine, Yale School of Medicine, New Haven, CT.
Pediatr Emerg Care. 2022 Feb 1;38(2):e821-e827. doi: 10.1097/PEC.0000000000002378.
We aimed to develop a parent-reported outcome measure for febrile infants 60 days or younger evaluated in the emergency department.
We conducted a 3-part study: (1) individual, semistructured interviews with parents of febrile infants 60 days or younger to generate potential items for the measure; (2) expert review with pediatric emergency medicine physicians and member checking with parents, who rated each item's clarity and relevance using 4-point scales; and (3) cognitive interviews with a new sample of parents, who gave feedback and rated the measure's ease of use on a 4-point scale. The measure was iteratively revised during each part of the development process.
In part 1, we interviewed 24 parents of 21 infants. Interviews revealed several themes: parents' experiences with medical care, communication, and decision making; parents' emotions, particularly worry, fear, and stress; the infant's outcomes valued by parents; and the impact of the infant's illness on the family. From these themes, we identified 22 potential items for inclusion in the measure. In part 2, 10 items were revised for clarity based on feedback from physicians and parents, primarily under the domains of parents' emotions and the infant's outcomes. In part 3, we further revised the measure for clarity and added an item. The final measure included 23 items and was rated as excellent in its ease of use.
The 23-item parent-reported outcome measure includes the experiences and outcomes important to parents. Further studies are needed to evaluate the measure's psychometric properties.
我们旨在为在急诊科就诊的 60 天或更年轻的发热婴儿开发一种父母报告的结局测量工具。
我们进行了 3 部分研究:(1)对 60 天或更年轻的发热婴儿的父母进行个体、半结构式访谈,以生成该测量工具的潜在项目;(2)儿科急诊医学医师进行专家审查,并与父母进行成员核对,父母使用 4 分制对每个项目的清晰度和相关性进行评分;(3)对新的父母样本进行认知访谈,父母提供反馈并对 4 分制的易用性进行评分。在开发过程的每个部分,该测量工具都进行了迭代修订。
在第 1 部分,我们采访了 21 名婴儿的 24 位父母。访谈揭示了几个主题:父母对医疗护理、沟通和决策的经历;父母的情绪,尤其是担忧、恐惧和压力;父母看重的婴儿结局;以及婴儿疾病对家庭的影响。从这些主题中,我们确定了 22 个潜在的项目纳入该测量工具。在第 2 部分,根据医师和父母的反馈,对 10 个项目进行了清晰度修订,主要在父母的情绪和婴儿的结局领域进行了修订。在第 3 部分,我们进一步修订了该测量工具的清晰度并添加了一个项目。最终的测量工具包括 23 个项目,其易用性被评为优秀。
23 项父母报告的结局测量工具包括父母认为重要的经历和结局。需要进一步的研究来评估该测量工具的心理测量学特性。