Chua Yi Ling, Toh Alyssa Jia Ning, Tan Xavier Yeow Boon, Pan Daryl Chen Yi, Lee Nicole Kim Luan, Lim Kevin Boon Leong
Department of Orthopaedic Surgery, KK Women's and Children's Hospital, Singapore.
Spine (Phila Pa 1976). 2023 May 1;48(9):617-624. doi: 10.1097/BRS.0000000000004585. Epub 2023 Jan 24.
Prospective cohort study.
The purpose of this study was to evaluate the relationship between patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs) in adolescent idiopathic scoliosis (AIS) managed nonsurgically with bracing or observation.
PREMs and PROMs are increasingly used to assess the effectiveness of patient-centered health care provision. To date, no study has attempted to study the relationship between PREMs and PROMs in AIS.
All patients who visited our one-stop, tertiary center for AIS between 2020 and 2021, were asked to complete pairs of PREMs and PROMs questionnaires. PREMs were evaluated using our institution's outpatient experience survey adapted from Hospital Consumer Assessment of Healthcare Providers and Systems survey. PROMs were determined via the Scoliosis Research Society-22 revised (SRS-22r) and European Quality of Life Five-Dimension Five-Level (EQ-5D-5L) forms.
In total, we included 730 patients who completed pairs of PREMs and PROMs questionnaires. 451 patients were treated by observation and 279 were braced. In the observation group, there was no association between patient experience and SRS-22r or EQ-5D-5L scores. In the brace group, improved SRS-22r were associated with higher PREM scores. In particular, having confidence and trust in treating physicians ( r =0.34), reporting that their worries and concerns were addressed during treatment ( r =0.34) and being taught self-care ( r =0.33, P <0.0001 for all) were most highly correlated with better SRS-22r scores.
In patients with AIS treated with bracing, improved patient experience was positively correlated with better patient reported outcomes, especially if patients' concerns were addressed during treatment and they received supportive care and education on self-care. In contrast, patient experience did not correlate with PROMs in children and adolescents with AIS who were under observation.
前瞻性队列研究。
本研究旨在评估在采用支具治疗或观察等非手术方法治疗的青少年特发性脊柱侧凸(AIS)患者中,患者报告的体验指标(PREMs)与患者报告的结局指标(PROMs)之间的关系。
PREMs和PROMs越来越多地用于评估以患者为中心的医疗服务的有效性。迄今为止,尚无研究试图探讨AIS患者中PREMs与PROMs之间的关系。
2020年至2021年间,所有到我们的一站式三级AIS中心就诊的患者都被要求完成一对PREMs和PROMs问卷。PREMs使用我们机构改编自《医疗服务提供者和系统的医院消费者评估》调查的门诊体验调查问卷进行评估。PROMs通过脊柱侧凸研究学会22项修订版(SRS-22r)和欧洲五维度五水平生活质量量表(EQ-5D-5L)表格来确定。
我们总共纳入了730名完成了一对PREMs和PROMs问卷的患者。451名患者接受观察治疗,279名患者接受支具治疗。在观察组中,患者体验与SRS-22r或EQ-5D-5L评分之间没有关联。在支具治疗组中,SRS-22r评分的改善与更高的PREM评分相关。特别是,对治疗医生有信心和信任(r = 0.34)、报告在治疗期间其担忧得到解决(r = 0.34)以及接受自我护理指导(r = 0.33,所有P < 0.0001)与更好的SRS-22r评分相关性最高。
在接受支具治疗的AIS患者中,患者体验的改善与更好的患者报告结局呈正相关,特别是如果患者的担忧在治疗期间得到解决,并且他们接受了支持性护理和自我护理教育。相比之下,在接受观察的AIS儿童和青少年中,患者体验与PROMs没有相关性。