Bryant Madeleine J, Munt Rebecca, Black Rachel J, Reynolds Amy, Hill Catherine L
Rheumatology Unit, The Queen Elizabeth Hospital, Central Adelaide Local Health Network,, Woodville South, SA, Australia.
Rheumatology Unit, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, SA, Australia.
Rheumatol Adv Pract. 2023 Aug 16;7(3):rkad068. doi: 10.1093/rap/rkad068. eCollection 2023.
People with rheumatic diseases are frequent, long-term attenders of health-care services. Their care experiences are central to improving services. The aim of this study was to explore real-world experiences and priorities of people attending outpatient rheumatology care and those of health-care professionals (HCPs) providing care.
This qualitative study consisted of five semi-structured focus groups. Participants included rheumatology outpatients ( = 16) of two tertiary teaching hospitals and HCPs ( = 14; rheumatologists, rheumatology trainees, physiotherapists, a specialty nurse and a pharmacist). Participants explored priorities when attending outpatient services, real experiences and aspirations for improving future care. Transcripts were coded using inductive and deductive thematic analysis.
Seven key themes were identified: smooth flow of technical processes, care coordination, individualized care, information sharing, clinical excellence, patient empowerment and comprehensive care. The findings were aligned conceptually with quality standards in Australia and worldwide. Different sub-themes and prioritization of concerns emerged from patient and HCP subgroups. Highly prioritized themes for patients pertained to processes and technical aspects of care. HCPs focused on themes relating to non-technical aspects of service provision: information sharing, individualization of care, patient advocacy and empowerment.
This study captured valuable insights into the current experience of outpatient rheumatology care from the perspective of patients and HCPs. It informs a collective understanding of differing and shared priorities, positives of current care and areas requiring change. Themes derived from the study data can be conceptualized in terms of the process, content and impact of care. Such domains can be measured longitudinally by routine implementation of validated patient-reported experience measures in rheumatology.
患有风湿性疾病的人经常且长期接受医疗服务。他们的就医体验对于改善服务至关重要。本研究的目的是探讨门诊风湿科患者以及提供护理的医疗保健专业人员（HCPs）的实际体验和优先事项。
这项定性研究包括五个半结构化焦点小组。参与者包括两家三级教学医院的风湿科门诊患者（n = 16）和HCPs（n = 14；风湿科医生、风湿科实习医生、物理治疗师、一名专科护士和一名药剂师）。参与者探讨了门诊服务的优先事项、实际体验以及对改善未来护理的期望。使用归纳和演绎主题分析法对转录本进行编码。
确定了七个关键主题：技术流程的顺畅、护理协调、个性化护理、信息共享、卓越临床、患者赋权和综合护理。这些发现与澳大利亚和全球的质量标准在概念上一致。患者和HCPs亚组出现了不同的子主题和关注点优先级。患者高度优先考虑的主题与护理的流程和技术方面有关。HCPs关注与服务提供的非技术方面相关的主题：信息共享、护理个性化、患者倡导和赋权。
本研究从患者和HCPs的角度获得了关于门诊风湿科护理当前体验的宝贵见解。它有助于对不同和共同的优先事项、当前护理的优点以及需要改变的领域形成集体理解。从研究数据中得出的主题可以根据护理的过程、内容和影响进行概念化。通过在风湿科常规实施经过验证的患者报告体验测量方法，可以纵向测量这些领域。
