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荷兰常规围产期护理中使用患者报告的结局和体验测量工具的女性体验:一项混合方法研究。

Women's experiences with using patient-reported outcome and experience measures in routine perinatal care in the Netherlands: a mixed-methods study.

机构信息

Department of Obstetrics and Gynaecology, Erasmus MC, Rotterdam, The Netherlands.

Department of Obstetrics and Gynaecology, UMC Utrecht, Utrecht, The Netherlands.

出版信息

BMJ Open. 2023 Mar 10;13(3):e064452. doi: 10.1136/bmjopen-2022-064452.

Abstract

OBJECTIVES

To gain insight into the experiences of women with completing and discussing patient-reported outcome measures (PROM) and patient-reported experience measures (PREM), and tailoring their care based on their outcomes.

DESIGN

A mixed-methods prospective cohort study.

SETTING

Seven obstetric care networks in the Netherlands that implemented a set of patient-centred outcome measures for pregnancy and childbirth (PCB set), published by the International Consortium for Health Outcomes Measurement.

PARTICIPANTS

All women, receiving the PROM and PREM questionnaires as part of their routine perinatal care, received an invitation for a survey (n=460) and an interview (n=16). The results of the survey were analysed using descriptive statistics; thematic inductive content analysis was applied on the data from open text answers and the interviews.

RESULTS

More than half of the survey participants (n=255) felt the need to discuss the outcomes of PROM and PREM with their care professionals. The time spent on completing questionnaires and the comprehensiveness of the questions was scored 'good' by most of the survey participants. From the interviews, four main themes were identified: content of the PROM and PREM questionnaires, application of these outcomes in perinatal care, discussing PREM and data capture tool. Important facilitators included awareness of health status, receiving personalised care based on their outcomes and the relevance of discussing PREM 6 months post partum. Barriers were found in insufficient information about the goal of PROM and PREM for individual care, technical problems in data capture tools and discrepancy between the questionnaire topics and the care pathway.

CONCLUSIONS

This study showed that women found the PCB set an acceptable and useful instrument for symptom detection and personalised care up until 6 months post partum. This patient evaluation of the PCB set has several implications for practice regarding the questionnaire content, role of care professionals and congruity with care pathways.

摘要

目的

了解女性完成和讨论患者报告的结局测量(PROM)和患者报告的体验测量(PREM)以及根据其结果调整护理的体验。

设计

一项混合方法前瞻性队列研究。

设置

荷兰的七个产科护理网络实施了一套由国际健康结局测量联合会发布的以患者为中心的妊娠和分娩结局测量(PCB 集)。

参与者

所有接受 PROM 和 PREM 问卷作为其围产期常规护理一部分的女性,均收到调查邀请(n=460)和访谈邀请(n=16)。调查结果采用描述性统计进行分析;对来自开放文本回答和访谈的数据进行主题归纳内容分析。

结果

超过一半的调查参与者(n=255)认为需要与护理专业人员讨论 PROM 和 PREM 的结果。大多数调查参与者对完成问卷所花费的时间和问题的全面性评分“良好”。从访谈中确定了四个主要主题:PROM 和 PREM 问卷的内容、这些结果在围产期护理中的应用、PREM 的讨论和数据采集工具。重要的促进因素包括对健康状况的认识、基于其结果获得个性化护理以及在产后 6 个月讨论 PREM 的相关性。发现的障碍包括缺乏有关个人护理的 PROM 和 PREM 目标的信息、数据采集工具的技术问题以及问卷主题与护理途径之间的差异。

结论

本研究表明,女性认为 PCB 集是一种可接受且有用的工具,可用于症状检测和个性化护理,直至产后 6 个月。这项对 PCB 集的患者评估对问卷内容、护理专业人员的角色以及与护理途径的一致性方面的实践具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/db71/10008176/10c4feb97004/bmjopen-2022-064452f01.jpg

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