Clinical Research Centre, CHI Créteil, Créteil, France
Université Paris-Est Créteil, Créteil, France.
BMJ Open. 2024 Aug 12;14(8):e082528. doi: 10.1136/bmjopen-2023-082528.
The quality of hospital care, especially surgery, is traditionally assessed using indicators derived from healthcare databases or safety indicators. Given the growing importance of placing the patient at the heart of care evaluation, the use of questionnaires such as the Patient-Reported Experience Measures and Patient-Reported Outcome Measures has become widespread in recent years. However, these tools-addressing factors such as satisfaction, pain management or wait times-only imperfectly reflect the patient's experience, and all such attempts at patient-centred care quality assessment rely on questions or indicators defined in advance by healthcare providers and health authorities. A biopsychosocial model may allow to better understand the patient experience and to improve care pathways. This study seeks to construct a narrative of the bariatric surgical care journey with instruments from narrative inquiry, propose a metanarrative that can serve as a basis for more sophisticated and reliable patient-focused care quality models and define indicators linked to patients' feelings and stories.
To achieve these aims, 16 bariatric surgical patients at the hospital of Créteil, France (Centre Hospitalier Intercommunal de Créteil), will be included and interviewed once before and twice after surgery, at months 3 and 6. Narratives collected will be used to construct a metanarrative intended to encompass all possible narratives. This metanarrative may ultimately inform new patient care quality indicators, furthering care focused on patients and tailored to their needs and predispositions.
The study is funded by the Group of Clinical Research and Innovation in Île-de-France and was approved by CPP SUD-EST VI Clermont-Ferrand (France) Research Ethics Committee. The results will be submitted for publication in peer-reviewed journals. The patient associations will be approached for the dissemination of the study results.
NCT05092659.
医院的医疗质量，尤其是外科手术的质量，传统上是使用从医疗保健数据库或安全指标中得出的指标来评估的。鉴于将患者置于护理评估的核心地位变得越来越重要，近年来，使用患者报告的体验测量和患者报告的结果测量等问卷已变得普遍。然而，这些工具——解决满意度、疼痛管理或等待时间等因素——仅能不完美地反映患者的体验，所有这些以患者为中心的护理质量评估方法都依赖于医疗保健提供者和卫生当局事先定义的问题或指标。生物心理社会模式可能有助于更好地理解患者的体验，并改善护理途径。本研究旨在通过叙事研究的工具构建减肥手术护理旅程的叙述，提出一个元叙事，作为更复杂和可靠的以患者为中心的护理质量模型的基础，并定义与患者感受和故事相关的指标。
为了实现这些目标，将纳入法国克里泰尔医院（Créteil 社区综合医院）的 16 名减肥手术患者，在手术前、手术后 3 个月和 6 个月分别进行一次访谈。收集的叙述将用于构建一个元叙述，旨在包含所有可能的叙述。这个元叙述最终可能会为新的患者护理质量指标提供信息，进一步关注患者，并根据他们的需求和倾向为他们量身定制护理。
该研究由法兰西岛临床研究和创新小组资助，并获得 CPP SUD-EST VI 克莱蒙费朗（法国）研究伦理委员会的批准。研究结果将提交给同行评议的期刊发表。将与患者协会联系，以传播研究结果。
NCT05092659。
