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疼痛治疗中复杂干预措施的结构与过程评估:以POET-疼痛为例的一种方法学描述

[Structure and process evaluation of complex interventions in pain therapy : Description of a methodological approach using the example of POET-Pain].

作者信息

Gnass Irmela, Berger Stefanie, Schürholz Nina, Kaiser Ulrike, Schäfer Axel, Schnabel Alexander, Pogatzki-Zahn Esther, Nestler Nadja

机构信息

Institut für Pflegewissenschaft und -praxis, Paracelsus Medizinische Privatuniversität, Strubergasse 21, 5020, Salzburg, Österreich.

Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Schleswig-Holstein, Deutschland.

出版信息

Schmerz. 2025 Feb;39(1):35-42. doi: 10.1007/s00482-024-00850-w. Epub 2024 Dec 10.

DOI:10.1007/s00482-024-00850-w
PMID:39656230
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11785641/
Abstract

To evaluate the quality of care, particularly in the case of new forms of healthcare interventions, the healthcare services to be provided are defined and documented in advance. The presented explanatory sequential mixed methods design combines quantitative and qualitative data collection and the analysis enables a deeper understanding of a new healthcare intervention. Using the example of the POET-Pain project, which investigates the effect of a perioperative transitional pain service (TPS), the methodological application of the explanatory sequential mixed methods design is demonstrated in order to present the structural and process evaluation of the new healthcare intervention (in this case TPS) and to understand its influence on the quality of care. The mixed methods design presented enables the results of the quantitative phase to be interpreted and expanded in depth using qualitative data, which leads to a comprehensive understanding of the subject matter (second pillar of health services research).

摘要

为评估医疗服务质量,尤其是在新型医疗干预措施的情况下,需预先定义并记录拟提供的医疗服务。本文提出的解释性序列混合方法设计结合了定量和定性数据收集,其分析能够更深入地理解一种新型医疗干预措施。以POET-疼痛项目为例,该项目研究围手术期过渡性疼痛服务(TPS)的效果,展示了解释性序列混合方法设计的方法应用,以呈现新型医疗干预措施(在本例中为TPS)的结构和过程评估,并了解其对医疗服务质量的影响。所提出的混合方法设计能够利用定性数据对定量阶段的结果进行深入解读和拓展,从而全面理解该主题(卫生服务研究的第二个支柱)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e6d/11785641/fbb574a3a7b7/482_2024_850_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e6d/11785641/20cfb6390b69/482_2024_850_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e6d/11785641/4e3890daef0c/482_2024_850_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e6d/11785641/90aa8f805cd1/482_2024_850_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e6d/11785641/fbb574a3a7b7/482_2024_850_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e6d/11785641/20cfb6390b69/482_2024_850_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e6d/11785641/4e3890daef0c/482_2024_850_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e6d/11785641/90aa8f805cd1/482_2024_850_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e6d/11785641/fbb574a3a7b7/482_2024_850_Fig4_HTML.jpg

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本文引用的文献

1
ICD-11: a major step forward towards the prediction and prevention of chronic postsurgical pain.《国际疾病分类第11版》:迈向慢性术后疼痛预测与预防的重要一步。
Eur J Anaesthesiol. 2024 Jun 1;41(6):399-401. doi: 10.1097/EJA.0000000000001996. Epub 2024 May 8.
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Prognostic models for chronic postsurgical pain-Current developments, trends, and challenges.慢性术后疼痛的预后模型——当前的发展、趋势和挑战。
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Chronic post-surgical pain - update on incidence, risk factors and preventive treatment options.
慢性术后疼痛——发病率、危险因素及预防性治疗选择的最新进展
BJA Educ. 2022 May;22(5):190-196. doi: 10.1016/j.bjae.2021.11.008. Epub 2022 Feb 24.
4
Rethinking the definition of chronic postsurgical pain: composites of patient-reported pain-related outcomes vs pain intensities alone.重新思考慢性术后疼痛的定义:患者报告的疼痛相关结局与单纯疼痛强度的组合。
Pain. 2022 Dec 1;163(12):2457-2465. doi: 10.1097/j.pain.0000000000002653. Epub 2022 Apr 19.
5
Opioid weaning and pain management in postsurgical patients at the Toronto General Hospital Transitional Pain Service.多伦多综合医院过渡性疼痛服务中心对术后患者的阿片类药物减量及疼痛管理
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A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance.制定和评估复杂干预措施的新框架:对医学研究理事会指南的更新。
BMJ. 2021 Sep 30;374:n2061. doi: 10.1136/bmj.n2061.
7
Current multidisciplinary approaches to preventing chronic postoperative pain.当前预防慢性术后疼痛的多学科方法。
Br J Anaesth. 2021 Sep;127(3):331-335. doi: 10.1016/j.bja.2021.04.018. Epub 2021 Jun 3.
8
[Psychosocial factors in the prevention of pain].[预防疼痛中的社会心理因素]
Schmerz. 2021 Feb;35(1):21-29. doi: 10.1007/s00482-020-00523-4. Epub 2021 Feb 3.
9
[Prediction and prevention of chronic postoperative pain].[慢性术后疼痛的预测与预防]
Schmerz. 2021 Feb;35(1):30-43. doi: 10.1007/s00482-020-00525-2. Epub 2021 Jan 20.
10
Opioid use among veterans undergoing major joint surgery managed by a multidisciplinary transitional pain service.多学科过渡性疼痛服务管理下的行大关节手术的退伍军人中的阿片类药物使用情况。
Reg Anesth Pain Med. 2020 Nov;45(11):847-852. doi: 10.1136/rapm-2020-101797. Epub 2020 Aug 26.