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绘制儿科血友病治疗单元中的患者体验:我们的患者旅程。

Mapping the Patient Experience in a Pediatric Hemophilia Unit: Our Patient Journey.

作者信息

Berrueco Rubén, Caballero Nuria, López-Tierling Mónica, Benedicto Cristina, González-Anleo Cristina, Rodríguez-Nieva Natalia, Nadal David, Vinyets Joan, Jabalera Mercedes

机构信息

Pediatric Hematology Department, Hospital Sant Joan de Déu, Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Spain.

Institut de Recerca Sant Joan de Déu de Barcelona (IRSJD), Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain.

出版信息

J Clin Med. 2024 Oct 18;13(20):6235. doi: 10.3390/jcm13206235.

DOI:10.3390/jcm13206235
PMID:39458185
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11508278/
Abstract

: Hemophilia is a rare X-linked bleeding disorder. Prophylaxis has improved outcomes, but there are still unmet needs to be addressed. The aim of this study was to develop a patient journey in pediatric patients with hemophilia, a visual tool that illustrates patients' relationship with the healthcare provider through time useful for identifying patient needs, potential concerns ("pain points"), and gaps in care. : qualitative study in a pediatric hemophilia unit using a human-centered design methodology. First stage: discover and empathize: (a) semi-structured interviews to patients/families and stakeholders; (b) observation techniques ("shadowing") to patients/families and professionals. Second stage: analyzing the collected information to create the patient journey. : A preliminary "clinical journey" was built using information from eight interviews with professionals from the interdisciplinary hemophilia team. Interviews with patient association representatives, 13 patients/families, and six "shadowing" techniques with patients and professionals were used to compare the "clinical journey" with the patient's reported experience. Main "pain points" were detected before diagnosis, at diagnosis, during assimilation, at treatment initiation, during training, and when patients start asking about their condition. The empowerment process was detected as a potential moment to improve patient/family experiences. : The patient journey helps to better understand patient/family experiences related to the disease in different scenarios. Caregivers and patient learning and empowerment processes are significant moments where the interdisciplinary team should focus to offer valuable solutions to improve outcomes. Further research is required in this area, particularly empirical research to amend or confirm the suggested patient journey.

摘要

血友病是一种罕见的X连锁出血性疾病。预防性治疗改善了治疗效果,但仍有未满足的需求有待解决。本研究的目的是为血友病患儿制定一份患者历程,这是一种可视化工具,通过时间展示患者与医疗服务提供者的关系,有助于识别患者需求、潜在问题(“痛点”)和护理差距。:在儿科血友病病房采用以人为本的设计方法进行定性研究。第一阶段:发现与共情:(a)对患者/家庭及利益相关者进行半结构化访谈;(b)对患者/家庭及专业人员采用观察技术(“跟踪观察”)。第二阶段:分析收集到的信息以创建患者历程。:利用对跨学科血友病团队专业人员进行的八次访谈所获得的信息构建了初步的“临床历程”。与患者协会代表、13名患者/家庭进行的访谈以及对患者和专业人员采用的六种“跟踪观察”技术,用于将“临床历程”与患者报告的经历进行比较。在诊断前、诊断时、适应过程中、治疗开始时、培训期间以及患者开始询问自身病情时发现了主要“痛点”。增强权能过程被视为改善患者/家庭体验的一个潜在时机。:患者历程有助于更好地理解患者/家庭在不同场景下与疾病相关的体验。护理人员以及患者的学习和增强权能过程是跨学科团队应重点关注的重要时刻,以便提供有价值的解决方案来改善治疗效果。该领域需要进一步研究,特别是实证研究,以修正或确认所建议的患者历程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/252e/11508278/3d13efd2b4ee/jcm-13-06235-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/252e/11508278/b03859b20edf/jcm-13-06235-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/252e/11508278/553109eb3e99/jcm-13-06235-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/252e/11508278/3d13efd2b4ee/jcm-13-06235-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/252e/11508278/b03859b20edf/jcm-13-06235-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/252e/11508278/553109eb3e99/jcm-13-06235-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/252e/11508278/3d13efd2b4ee/jcm-13-06235-g003.jpg

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本文引用的文献

1
The CDH patient perspective journey.先天性髋关节发育不良患者的视角历程。
Front Pediatr. 2023 Feb 21;11:1052422. doi: 10.3389/fped.2023.1052422. eCollection 2023.
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Nurse-led education of people with bleeding disorders and their caregivers: A scoping review.护士主导的出血性疾病患者及其照护者教育:范围综述。
Haemophilia. 2022 Nov;28(6):e153-e163. doi: 10.1111/hae.14629. Epub 2022 Jul 18.
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The GOAL-Hēm journey: Shared decision making and patient-centred outcomes.GOAL-Hēm 之旅:共同决策和以患者为中心的结果。
Haemophilia. 2022 Sep;28(5):784-795. doi: 10.1111/hae.14608. Epub 2022 Jun 21.
4
The Hemophilia Gene Therapy Patient Journey: Questions and Answers for Shared Decision-Making.血友病基因治疗患者历程:共同决策的问答
Patient Prefer Adherence. 2022 Jun 9;16:1439-1447. doi: 10.2147/PPA.S355627. eCollection 2022.
5
Living with a "hemophilia-free mind" - The new ambition of hemophilia care?以“无血友病心态”生活——血友病护理的新目标?
Res Pract Thromb Haemost. 2021 Aug 3;5(5):e12567. doi: 10.1002/rth2.12567. eCollection 2021 Jul.
6
Patient-relevant health outcomes for hemophilia care: Development of an international standard outcomes set.血友病护理中与患者相关的健康结局:国际标准结局集的制定
Res Pract Thromb Haemost. 2021 Mar 6;5(4):e12488. doi: 10.1002/rth2.12488. eCollection 2021 May.
7
Management of children with hemophilia A: How emicizumab has changed the landscape.血友病 A 患儿的管理:依库珠单抗如何改变现状。
J Thromb Haemost. 2021 Jul;19(7):1629-1637. doi: 10.1111/jth.15342. Epub 2021 May 21.
8
The patient journey to diagnosis and treatment of congenital sucrase-isomaltase deficiency.先天性蔗糖-异麦芽糖酶缺乏症的诊断和治疗的患者旅程。
Qual Life Res. 2021 Aug;30(8):2329-2338. doi: 10.1007/s11136-021-02819-z. Epub 2021 Mar 27.
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WFH Guidelines for the Management of Hemophilia, 3rd edition.《血友病管理的居家指南》第三版
Haemophilia. 2020 Aug;26 Suppl 6:1-158. doi: 10.1111/hae.14046. Epub 2020 Aug 3.
10
How Do I Counsel Parents of a Newly Diagnosed Boy with Haemophilia A?如何为新诊断为 A 型血友病的男孩的父母提供咨询?
Hamostaseologie. 2020 Feb;40(1):88-96. doi: 10.1055/s-0039-3402805. Epub 2020 Jan 28.