Pitkänen Laura J, Niskanen Jyri, Malmivaara Antti, Torkki Paulus
Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Unit for Performance Assessment of the Health and Social Service System, Finnish Institute of Health and Welfare, Helsinki, Finland.
Front Health Serv. 2023 Sep 15;3:1187713. doi: 10.3389/frhs.2023.1187713. eCollection 2023.
A feasible system for measuring patient outcomes of rehabilitation is required for assessing the real-world cost-effectiveness of rehabilitation. This study aims to assess the feasibility of measuring outcomes of rehabilitation among elderly individuals with early-stage Alzheimer's. We used the principles of Design Science to construct a set of metrics consisting of standardized PROM (Patient-Reported Outcome Measure) questionnaires, clinician-reported measures, and observational measures of functioning. We used standardized questionnaires whenever possible to ensure the validity and reliability of the questionnaires. The set of metrics was piloted on 16 individuals living at home with regular home care services. After the pilot, we further refined the set of metrics based on relevance, sensitivity to change, and applicability. We found that measurement was feasible and we propose the final set of metrics as a minimum set, which could be further improved upon by addition of metrics relevant to each subgroup of elderly individuals. We also found that using self-reported questionnaires in this population is not without difficulties. We therefore suggest that the role of informal caregivers be considered, and that accessibility of outcome questionnaires be improved.
为评估康复在现实世界中的成本效益，需要一个可行的系统来衡量康复的患者结局。本研究旨在评估在患有早期阿尔茨海默病的老年人中衡量康复结局的可行性。我们运用设计科学的原则构建了一套指标体系，该体系由标准化的患者报告结局量表问卷、临床医生报告的测量指标以及功能观察指标组成。只要有可能，我们就使用标准化问卷以确保问卷的有效性和可靠性。这套指标体系在16名接受定期居家护理服务的居家老年人中进行了试点。试点之后，我们基于相关性、对变化的敏感性和适用性对指标体系进行了进一步完善。我们发现测量是可行的，并且我们提出最终的指标体系作为一个最小集，通过添加与每个老年人群体亚组相关的指标可以对其进一步改进。我们还发现，在这个群体中使用自我报告问卷并非没有困难。因此，我们建议考虑非正式照料者的作用，并提高结局问卷的可及性。
