质量指标从儿科过渡到成人保健的青年与慢性疾病：提议的在线修正德尔菲研究。
Quality Indicators for Transition from Pediatric to Adult Care for Youth With Chronic Conditions: Proposal for an Online Modified Delphi Study.
机构信息
Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Department of Adolescent Medicine, The Hospital for Sick Children, Toronto, ON, Canada.
出版信息
JMIR Res Protoc. 2024 Sep 10;13:e60860. doi: 10.2196/60860.
BACKGROUND
The transition from pediatric to adult care poses a significant health system-level challenge impeding the delivery of quality health services for youth with chronic health conditions. In Canada and globally, the transition to adult care is regarded as a top priority in adolescent health in need of readily applicable, adaptable, and relevant national metrics to evaluate and benchmark transition success across disease populations and clinical care settings. Unfortunately, existing literature fails to account for the lack of engagement from youth and caregivers in developing indicators, and its applicability across chronic conditions, primary care involvement, and health equity considerations.
OBJECTIVE
Our proposed study aims to establish a consensus-driven set of quality indicators for the transition to adult care that are universally applicable across physical, developmental, and mental health conditions, clinical care settings, and health jurisdictions.
METHODS
Using an integrated knowledge translation (iKT) approach, a panel comprising youth, caregivers, interdisciplinary health care providers, and health system leaders will be established to collaborate with our research team to ensure that the study methodology, materials, and knowledge dissemination are suitable and reflect the perspectives of youth and their families. We will then conduct an iterative 3-round Online Modified Delphi (OMD) study (n=160) to (1) compare and contrast the perspectives of youth, caregivers, health care providers, and health system leaders on quality indicators for transition; and (2) prioritize a key set of quality indicators for transition applicable across disease populations that are the most important, useful, and feasible in the Canadian context. Using the RAND/UCLA Appropriateness Method (RAM) multistage analytic approach, data from each panel and stakeholder group will be examined separately and compared to establish a key set of indicators endorsed by both panels.
RESULTS
The study is funded by the Canadian Institutes of Health Research and Physicians Services Incorporated.
CONCLUSIONS
This study will produce quality indicators to evaluate and inform action equitably to improve transition from pediatric to adult care for youth and their families in Canada.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/60860.
背景
儿科到成人护理的过渡对卫生系统提出了重大挑战，阻碍了为患有慢性健康状况的青年提供优质卫生服务。在加拿大和全球范围内，向成人护理的过渡被视为青少年健康的首要任务，需要易于应用、可调整和相关的国家指标来评估和基准化跨疾病人群和临床护理环境的过渡成功。不幸的是，现有文献未能考虑到青年和照顾者在制定指标方面缺乏参与，以及其在跨慢性疾病、初级保健参与和卫生公平考虑方面的适用性。
目的
我们拟开展的研究旨在建立一套共识驱动的过渡到成人护理的质量指标，这些指标在物理、发育和心理健康状况、临床护理环境和卫生司法管辖区中普遍适用。
方法
采用综合知识转化（iKT）方法，成立一个由青年、照顾者、跨学科医疗保健提供者和卫生系统领导者组成的小组，与我们的研究团队合作，确保研究方法、材料和知识传播既合适又反映青年及其家庭的观点。然后，我们将进行一项迭代的 3 轮在线改良 Delphi（OMD）研究（n=160），（1）比较和对比青年、照顾者、医疗保健提供者和卫生系统领导者对过渡质量指标的看法；（2）确定一组在加拿大背景下最重要、最有用和最可行的适用于跨疾病人群的过渡质量指标。使用 RAND/UCLA 适宜性方法（RAM）多阶段分析方法，单独检查每个小组和利益相关者群体的数据，并将其与两个小组都认可的指标进行比较，以确定一组关键指标。
结果
该研究由加拿大卫生研究院和医师服务公司资助。
结论
本研究将制定质量指标，以评估和为加拿大青年及其家庭从儿科到成人护理的过渡提供信息，促进公平行动。
国际注册报告标识符（IRRID）：PRR1-10.2196/60860。
Zotero 插件