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一项验证患者报告体验测量(PREM)工具在印度伤口管理与安全方面应用的多中心研究。

A Multicentric Study to Validate the Patient-Reported Experience Measures (PREM) Tool for Wound Management and Safety in India.

作者信息

Michael Jothi C, Murugesan Malathi, Murthy V B Narayana, Seetharaman Selva, Sharmil Hepsibah, Rosy Hannah J, Manjrekar Phalakshi, Shanmugam Rajendran Shankar, Gomez Thankam

机构信息

Health Policy, Healthbridge, Chennai, IND.

Microbiology, Meenakshi Mission Hospital and Research Centre, Madurai, IND.

出版信息

Cureus. 2025 Jul 17;17(7):e88176. doi: 10.7759/cureus.88176. eCollection 2025 Jul.

Abstract

BACKGROUND

Effective wound management is a vital aspect of healthcare that significantly influences patient morbidity and mortality. While traditional wound care quality assessments focus on clinical outcomes such as healing rates, infection control, and recurrence, patient experience during wound therapy remains an important yet underexplored dimension of care quality.

OBJECTIVE

This multi-centric prospective study aimed to develop and validate a Patient Reported Experience Measures (PREM) tool specifically designed to capture patient perspectives on safety, communication, infection prevention, and overall care during wound dressing procedures within the Indian healthcare setting.

METHODS

Seventeen hospitals across diverse geographic regions and varying sizes in India participated. The PREM tool was developed through a systematic process involving iterative surveys, focus group discussions with healthcare professionals, and pilot testing. The initial tool included 19 items covering communication, infection control, patient education, privacy, and patient identification. After pilot testing with 170 patients, the instrument was refined and administered to 904 patients. Psychometric validation was performed using confirmatory factor analysis (CFA).

RESULTS

The PREM tool demonstrated excellent reliability with a Kuder-Richardson Formula 20 (KR-20) internal consistency coefficient of 0.748. Majority of patients reported positive experiences: 91.3% confirmed name and ID verification prior to dressing, 95.7% received procedure explanations, 100% observed infection control practices, and 97.6% reported maintained privacy. However, only 56.7% received adequate training for home wound care, and 59.1% could demonstrate dressing techniques to healthcare providers, highlighting a need for improved patient education. Enhanced patient adherence to infection control measures reflected increased awareness following the COVID-19 pandemic.

CONCLUSION

The study underscores the importance of incorporating patient feedback into wound care quality evaluation, complementing traditional clinical outcomes with experiential factors that influence patient satisfaction and adherence. The validated PREM tool offers a structured framework for healthcare providers to assess and enhance the wound care experience, promoting patient-centered care. Future research should focus on cross-cultural validation, demographic diversification, and integration of PREM data with clinical parameters to improve wound care quality comprehensively.

摘要

背景

有效的伤口管理是医疗保健的一个重要方面,对患者的发病率和死亡率有重大影响。虽然传统的伤口护理质量评估侧重于临床结果,如愈合率、感染控制和复发情况,但伤口治疗期间患者的体验仍然是护理质量的一个重要但未得到充分探索的维度。

目的

这项多中心前瞻性研究旨在开发并验证一种患者报告体验测量(PREM)工具,该工具专门设计用于获取印度医疗环境中患者在伤口换药过程中对安全、沟通、感染预防和整体护理的看法。

方法

印度不同地理区域、不同规模的17家医院参与了研究。PREM工具是通过一个系统的过程开发的,包括反复调查、与医疗专业人员进行焦点小组讨论以及试点测试。最初的工具包括19个项目,涵盖沟通、感染控制、患者教育、隐私和患者识别。在对170名患者进行试点测试后,该工具得到完善并应用于904名患者。使用验证性因子分析(CFA)进行心理测量学验证。

结果

PREM工具显示出出色的信度,库德 - 理查森公式20(KR - 20)内部一致性系数为0.748。大多数患者报告了积极的体验:91.3%的患者确认在换药前进行了姓名和身份验证,95.7%的患者接受了操作解释,100%的患者观察到了感染控制措施,97.6%的患者报告隐私得到了保护。然而,只有56.7%的患者接受了足够的家庭伤口护理培训,59.1%的患者能够向医疗服务提供者展示换药技术,这凸显了改进患者教育的必要性。患者对感染控制措施的依从性增强反映出在新冠疫情之后意识有所提高。

结论

该研究强调了将患者反馈纳入伤口护理质量评估的重要性,用影响患者满意度和依从性的体验因素补充传统的临床结果。经过验证的PREM工具为医疗服务提供者提供了一个结构化框架,以评估和提升伤口护理体验,促进以患者为中心的护理。未来的研究应侧重于跨文化验证、人口统计学多样化以及将PREM数据与临床参数整合,以全面提高伤口护理质量。

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