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多专业诊所中初级保健质量的患者自我评价工具的系统文献回顾。

A systematic literature review of patient self-assessment instruments concerning quality of primary care in multiprofessional clinics.

机构信息

Department of General Practice, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR, France.

ER 7479 SPURBO, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR, France.

出版信息

Fam Pract. 2022 Sep 24;39(5):951-963. doi: 10.1093/fampra/cmac007.

Abstract

BACKGROUND

Quality of care remains a priority issue and is correlated with patient experience. Measuring multidimensional patient primary care experiences in multiprofessional clinics requires a robust instrument. Although many exist, little is known about their quality.

OBJECTIVE

To identify patient perception instruments in multiprofessional primary care and evaluate their quality.

METHODS

Systematic review using Medline, Pascal, PsycINFO, Google Scholar, Cochrane, Scopus, and CAIRN. Eligible articles developed, evaluated, or validated 1 or more self-assessment instruments. The instruments had to measure primary care delivery, patient primary care experiences and assess at least 3 quality-of-care dimensions. The COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) checklist was used to assess methodological quality of included studies. Instrument measurement properties were appraised using 3 possible quality scores. Data were combined to provide best-evidence synthesis based on the number of studies, their methodological quality, measurement property appraisal, and result consistency. Subscales used to capture patient primary care experiences were extracted and grouped into the 9 Institute of Medicine dimensions.

RESULTS

Twenty-nine articles were found. The included instruments captured many subscales illustrating the diverse conceptualization of patient primary care experiences. No included instrument demonstrated adequate validity and the lack of scientific methodology for assessing reliability made interpreting validity questionable. No study evaluated instrument responsiveness.

CONCLUSION

Numerous patient self-assessment instruments were identified capturing a wide range of patient experiences, but their measurement properties were weak. Research is required to develop and validate a generic instrument for assessing quality of multiprofessional primary care.

TRIAL REGISTRATION

Not applicable.

摘要

背景

医疗质量仍然是一个优先事项,与患者体验相关。在多专业诊所中测量多维患者初级保健体验需要一个强大的工具。尽管有很多工具,但对它们的质量知之甚少。

目的

确定多专业初级保健中的患者感知工具,并评估其质量。

方法

使用 Medline、Pascal、PsycINFO、Google Scholar、Cochrane、Scopus 和 CAIRN 进行系统评价。合格的文章开发、评估或验证了 1 个或多个自我评估工具。这些工具必须测量初级保健服务的提供、患者的初级保健体验,并评估至少 3 个质量维度。使用基于共识的健康状况测量仪器选择标准(COSMIN)清单来评估纳入研究的方法学质量。使用 3 种可能的质量评分来评估仪器的测量特性。根据研究数量、方法学质量、测量特性评估和结果一致性,对数据进行组合,提供最佳证据综合。提取用于捕获患者初级保健体验的子量表,并将其分组到医学研究所的 9 个维度中。

结果

发现 29 篇文章。所包括的工具捕获了许多子量表,说明了患者初级保健体验的多样化概念化。没有一个包括的工具表现出足够的有效性,缺乏评估可靠性的科学方法使得解释有效性值得怀疑。没有研究评估仪器的反应性。

结论

确定了许多患者自我评估工具,这些工具捕获了广泛的患者体验,但它们的测量特性较弱。需要研究开发和验证一种用于评估多专业初级保健质量的通用工具。

注册

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ce3/9508876/aae276cde7f0/cmac007f0001.jpg

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