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儿童医疗复杂性患者的医院-家庭过渡:第 2 部分 - 核心结局集。

Hospital-to-home transitions for children with medical complexity: part 2-a core outcome set.

机构信息

Department of Pediatric Intensive Care Unit, Amsterdam Reproduction and Development, Amsterdam UMC location University of Amsterdam, Emma Children's Hospital, Meibergdreef 9, Amsterdam, The Netherlands.

Department of Pediatric and Neonatal Intensive Care, Division of Paediatric Intensive Care, Erasmus MC-Sophia Children's Hospital, Rotterdam, 3015 CN, The Netherlands.

出版信息

Eur J Pediatr. 2023 Sep;182(9):3833-3843. doi: 10.1007/s00431-023-05049-2. Epub 2023 Jun 20.

Abstract

Appropriate outcome measures as part of high-quality intervention trials are critical to advancing hospital-to-home transitions for Children with Medical Complexity (CMC). Our aim was to conduct a Delphi study and focus groups to identify a Core Outcome Set (COS) that healthcare professionals and parents consider essential outcomes for future intervention research. The development process consisted of two phases: (1) a three-round Delphi study in which different professionals rated outcomes, previously described in a systematic review, for inclusion in the COS and (2) focus groups with parents of CMC to validate the results of the Delphi study. Forty-five professionals participated in the Delphi study. The response rates were 55%, 57%, and 58% in the three rounds, respectively. In addition to the 24 outcomes from the literature, the participants suggested 12 additional outcomes. The Delphi rounds resulted in the following core outcomes: (1) disease management, (2) child's quality of life, and (3) impact on the life of families. Two focus groups with seven parents highlighted another core outcome: (4) self-efficacy of parents.   Conclusion: An evidence-informed COS has been developed based on consensus among healthcare professionals and parents. These core outcomes could facilitate standard reporting in future CMC hospital to home transition research. This study facilitated the next step of COS development: selecting the appropriate measurement instruments for every outcome. What is Known: • Hospital-to-home transition for Children with Medical Complexity is a challenging process. • The use of core outcome sets could improve the quality and consistency of research reporting, ultimately leading to better outcomes for children and families. What is New: • The Core Outcome Set for transitional care for Children with Medical Complexity includes four outcomes: disease management, children's quality of life, impact on the life of families, and self-efficacy of parents.

摘要

适当的结局测量指标是推进患有复杂疾病儿童(CMC)从医院到家庭过渡的高质量干预试验的关键。我们的目的是进行一项德尔菲研究和焦点小组,以确定医疗保健专业人员和家长认为对未来干预研究至关重要的核心结局集(COS)。该开发过程包括两个阶段:(1)在三轮德尔菲研究中,不同的专业人员对之前在系统评价中描述的结局进行评分,以确定是否纳入 COS;(2)对 CMC 的家长进行焦点小组讨论,以验证德尔菲研究的结果。45 名专业人员参与了德尔菲研究。三轮的回复率分别为 55%、57%和 58%。除了文献中的 24 个结局外,参与者还提出了 12 个额外的结局。德尔菲研究结果得出以下核心结局:(1)疾病管理;(2)儿童的生活质量;(3)对家庭生活的影响。两个由七名家长参加的焦点小组强调了另一个核心结局:(4)父母的自我效能感。结论:基于医疗保健专业人员和家长之间的共识,制定了一个基于证据的 COS。这些核心结局可以促进未来 CMC 从医院到家庭过渡研究的标准报告。本研究为 COS 开发的下一步提供了便利:为每个结局选择合适的测量工具。已知情况:•患有复杂疾病的儿童从医院到家庭的过渡是一个具有挑战性的过程。•核心结局集的使用可以提高研究报告的质量和一致性,最终为儿童和家庭带来更好的结果。新情况:•患有复杂疾病的儿童过渡性护理的核心结局集包括四个结局:疾病管理、儿童生活质量、对家庭生活的影响和父母的自我效能感。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/653c/10570151/e8adc75cab70/431_2023_5049_Fig1_HTML.jpg

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