Centre for Quality and Patient Safety, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, Geelong, Victoria, Australia.
Monash Nursing and Midwifery, Monash University, Victoria, Melbourne, Australia.
J Clin Nurs. 2023 Aug;32(15-16):4249-4264. doi: 10.1111/jocn.16598. Epub 2023 Jan 5.
The aim of this systematic review was to examine the methodological quality of dignity-related patient reported outcome measures (PROMs) used to measure patients' dignity during acute hospitalisation using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology for systematic review of PROMs.
Previous scoping review studies on the methodological quality of dignity-related PROMs lack specificity for dignity during acute hospital admission. They included PROMs that were developed to measure constructs of care other than patient dignity or designed to measure dignity in contexts outside of the acute hospital setting.
A systematic review based on COSMIN methodology.
A systematic search was undertaken using five databases (CINAHL Complete, Medline Complete, EMBASE, PsycINFo and AgeLine) for articles published between 2000 and 2022. Relevant papers were identified using strict adherence to eligibility criteria, and studies that included development of dignity-related PROMs for use in acute hospital settings were selected. Two reviewers independently screened the identified papers, extracted data and examined the quality of studies.
Six papers met the inclusion criteria. Two PROMs, the 25-item Patient Dignity Inventory and the 34-item Inpatient Dignity Scale, met the COSMIN quality criteria because of their sufficient quality of evidence for content validity and reliable internal consistency. None of the PROMs met the quality criteria for assessment of measurement error, criterion validity, cross-cultural validity and responsiveness.
We recommend the Patient Dignity Inventory and the Inpatient Dignity Scale as the PROMs of choice for evaluating patients' dignity and/or dignified care during acute hospital admissions. These PROMs were developed using robust procedures with sufficient overall quality for content validity, internal consistency reliability and other measurement properties, and with moderate to high quality of evidence for these measurement properties. Researchers and clinicians who wish to use other dignity-related PROMs identified in this review should consider the methodological limitations of these PROMs, as highlighted in the present systematic review.
The review findings will guide healthcare professionals about their choice of patient reported outcome measures for evaluating patients' dignity or dignified care during acute hospitalisation.
本系统评价的目的是使用共识基础的健康测量仪器选择标准（COSMIN）系统评价患者报告结局测量（PROM）方法学，检查用于测量急性住院期间患者尊严的与尊严相关的 PROM 的方法学质量。
以前关于与尊严相关的 PROM 方法学质量的范围综述研究缺乏对急性住院期间尊严的特异性。它们包括旨在测量护理结构而不是患者尊严的 PROM，或旨在测量急性医院环境之外的尊严的 PROM。
基于 COSMIN 方法的系统评价。
使用五个数据库（CINAHL Complete、Medline Complete、EMBASE、PsycINFo 和 AgeLine）对 2000 年至 2022 年期间发表的文章进行了系统搜索。使用严格的纳入标准确定相关文章，并选择了在急性医院环境中开发与尊严相关的 PROM 的研究。两名审查员独立筛选确定的论文，提取数据并检查研究质量。
符合纳入标准的有 6 篇论文。两个 PROM，即 25 项患者尊严量表和 34 项住院患者尊严量表，由于其内容有效性和可靠的内部一致性的证据质量充足，符合 COSMIN 质量标准。没有一个 PROM符合测量误差、效标效度、跨文化有效性和反应性的质量标准。
我们建议将患者尊严量表和住院患者尊严量表作为评估急性住院患者尊严和/或尊严护理的首选 PROM。这些 PROM 是使用具有足够内容有效性、内部一致性可靠性和其他测量特性的稳健程序开发的，并且具有这些测量特性的中等到高质量的证据。希望在本研究中使用其他与尊严相关的 PROM 的研究人员和临床医生应考虑这些 PROM 的方法学局限性，正如本系统评价所强调的那样。
本综述的研究结果将指导医疗保健专业人员选择患者报告结局测量，以评估急性住院期间患者的尊严或尊严护理。
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