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[电子满意度:一种分析患者报告结局指标(PROMs)的新方法]

[E-Satis : A new method for analysis of Patient-Reported Outcome Measures (PROMs)].

作者信息

Crubezy M, Haesebaert J, Geig A, Michel P

机构信息

Research on Healthcare Performance (RESHAPE), Inserm U1290, Université Claude Bernard Lyon 1, 69008, Lyon, France; Institut d'études KPAM, 75002, Paris, France.

Research on Healthcare Performance (RESHAPE), Inserm U1290, Université Claude Bernard Lyon 1, 69008, Lyon, France; Pôle de santé publique et Service recherche épidémiologie cliniques, Hospices Civils de Lyon, 69002, Lyon, France.

出版信息

Rev Epidemiol Sante Publique. 2023 Jun;71(3):101839. doi: 10.1016/j.respe.2023.101839. Epub 2023 Apr 28.

Abstract

OBJECTIVE

Almost 80% of the patients responding to the nationwide French patient experience and satisfaction survey (e-Satis) provided free text comments. The objective of this article is to describe an innovative methodology for analysis of this qualitative data.

METHODOLOGY

This methodological approach is based on analysis of qualitative data from the comments (verbatims) of respondents to the e-Satis survey. Analysis of the verbatims consists in three main steps: (i) analysis of the meaning of the words, with constitution of a thematic dictionary through exploratory research without preconceived notions; (ii) analysis of the syntax, i.e., the way in which the ideas are articulated, which will enable calculation of a linguistic indicator of speakers' involvement in their speech; (iii) production of statistics and characterisation of the themes, which will include three indicators: occurrence of the themes, the average satisfaction shown in the respondents' discourse, and the positive and negative involvement with which they express themselves. Given these results, a priority matrix of four categories of action is established: strong points, priority areas, good practices, and weak signals.

RESULTS

This methodological approach was applied to 5868 e-Satis questionnaires out of a total of 10,061 verbatims by respondents hospitalised at the Hospices Civils de Lyon between 2018 and 2019. The analysis identified 28 major themes with 184 sub-themes. An extract is presented in this article for illustration purposes.

DISCUSSION

A methodological approach based on analysis of qualitative data will enable transformation of unstructured data (verbatims) into measurable and comparable data. This methodology is structured to overcome the limitations of closed questions; open questions allow respondents to describe their experiences and perceptions in their own words. Moreover, it is a first step toward comparability of results over time with those of other establishments. This approach is unique in France on account of (a) its exploratory thematic research without preconceived notions and (b) its syntactic analysis of verbatims.

CONCLUSIONS

This verbatim analysis methodology should enable precise and operational characterization of Patient Experience and induce prioritized improvement actions in healthcare institutions.

摘要

目的

在法国全国性患者体验与满意度调查(e-Satis)中做出回应的患者,近80%提供了自由文本评论。本文的目的是描述一种用于分析此类定性数据的创新方法。

方法

这种方法基于对e-Satis调查受访者评论(逐字记录)中的定性数据进行分析。对逐字记录的分析包括三个主要步骤:(i)词汇含义分析,通过无先入之见的探索性研究构建主题词典;(ii)句法分析,即观点的表达结构方式,这将有助于计算说话者在其话语中的参与度语言指标;(iii)生成统计数据并对主题进行特征描述,其中包括三个指标:主题出现频率、受访者话语中显示的平均满意度,以及他们表达自身的积极和消极参与度。基于这些结果,建立了一个四类行动的优先矩阵:优点、优先领域、良好做法和薄弱信号。

结果

该方法应用于2018年至2019年期间在里昂公民医院住院的受访者提供的10,061条逐字记录中的5868份e-Satis问卷。分析确定了28个主要主题和184个子主题。本文为说明目的给出了一个摘录。

讨论

基于定性数据分析的方法将使非结构化数据(逐字记录)转化为可测量和可比的数据。这种方法的构建旨在克服封闭式问题的局限性;开放式问题允许受访者用自己的语言描述他们的经历和看法。此外,这是朝着与其他机构的结果随时间的可比性迈出 的第一步。由于(a)其无先入之见的探索性主题研究和(b)对逐字记录的句法分析,这种方法在法国是独一无二的。

结论

这种逐字记录分析方法应能对患者体验进行精确且可操作的特征描述,并促使医疗机构采取优先改进行动。

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