Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, King's College London, London, UK.
The Royal Marsden NHS Foundation Trust, London, UK.
Patient. 2023 Sep;16(5):473-483. doi: 10.1007/s40271-023-00627-w. Epub 2023 May 23.
Self-reported health data from children with life-limiting conditions is rarely collected. To improve acceptability and feasibility of child and family-centred outcome measures for children, they need to be designed in a way that reflects preferences, priorities and abilities.
The aim was to identify preferences for patient-reported outcome measure design (recall period, response format, length, administration mode) to improve the feasibility, acceptability, comprehensibility and relevance of a child and family-centred outcome measure, among children with life-limiting conditions and their family members.
A semi-structured qualitative interview study seeking the perspectives of children with life-limiting conditions, their siblings and parents on measure design was conducted. Participants were purposively sampled and recruited from nine UK sites. Verbatim transcripts were analysed using framework analysis.
A total of 79 participants were recruited: 39 children aged 5-17 years (26 living with a life-limiting condition; 13 healthy siblings) and 40 parents (of children aged 0-17 years). Children found a short recall period and a visually appealing measure with ten questions or fewer most acceptable. Children with life-limiting conditions were more familiar with using rating scales such as numeric and Likert than their healthy siblings. Children emphasised the importance of completing the measure alongside interactions with a healthcare professional to enable them to talk about their responses. While parents assumed that electronic completion methods would be most feasible and acceptable, a small number of children preferred paper.
This study demonstrates that children with life-limiting conditions can engage in communicating preferences regarding the design of a patient-centred outcome measure. Where possible, children should be given the opportunity to participate in the measure development process to enhance acceptability and uptake in clinical practice. Results of this study should be considered in future research on outcome measure development in children.
很少收集患有危及生命疾病的儿童的自我报告健康数据。为了提高以儿童和家庭为中心的结局测量工具的可接受性和可行性,需要以反映偏好、优先事项和能力的方式进行设计。
旨在确定患者报告结局测量工具设计(回忆期、应答格式、长度、管理模式)的偏好,以提高患有危及生命疾病的儿童及其家庭成员的以儿童和家庭为中心的结局测量工具的可行性、可接受性、理解性和相关性。
采用半结构化定性访谈研究,从九个英国地点有目的地抽样招募患有危及生命疾病的儿童、其兄弟姐妹和父母,以了解他们对测量工具设计的看法。使用框架分析对逐字记录进行分析。
共招募了 79 名参与者:39 名 5-17 岁的儿童(26 名患有危及生命的疾病;13 名健康的兄弟姐妹)和 40 名父母(子女年龄为 0-17 岁)。儿童认为较短的回忆期和具有 10 个问题或更少问题且具有吸引力的量表最容易接受。患有危及生命疾病的儿童比其健康的兄弟姐妹更熟悉使用评分量表,如数字和李克特量表。儿童强调在与医疗保健专业人员进行互动的同时完成测量的重要性,以便他们能够谈论自己的回答。虽然父母认为电子完成方法最可行和可接受,但少数儿童更喜欢纸质。
本研究表明,患有危及生命疾病的儿童可以就以患者为中心的结局测量工具的设计进行沟通偏好。在可能的情况下,应让儿童有机会参与测量工具的开发过程,以提高在临床实践中的可接受性和使用率。本研究的结果应在未来儿童结局测量工具开发的研究中加以考虑。