Liu Kyara J, Pituch Evelina, Barrett Kathryn, Berndl Anne, Graves Lisa, Lunsky Yona, Vainder Marina, Camden Andi, Evans Meredith, Tarasoff Lesley A, Brown Hilary K
Dalla Lana School of Public Health, University of Toronto, Toronto, ON.
Department of Health and Society, University of Toronto Scarborough, Toronto, ON.
J Obstet Gynaecol Can. 2025 Nov;47(11):103106. doi: 10.1016/j.jogc.2025.103106. Epub 2025 Sep 10.
This study aimed to develop quality indicators (QIs) for pregnancy care of people with disabilities.
We used a RAND-modified Delphi method. We first conducted a scoping review of Medline, Embase, PsycInfo, and CINAHL (2004-2024) to identify candidate QIs related to the structures, clinical processes, and interpersonal processes of pregnancy care for people with disabilities. Draft QIs were then validated in a 3-round Delphi study from June 2023 to October 2024, with an expert panel of 17 pregnancy care providers and 10 birthing people with disabilities. In round 1, panellists rated draft QIs on importance and feasibility in a survey. New QIs and QIs requiring rephrasing were identified. In round 2, QIs were discussed and refined in focus groups. In round 3, panellists rated new and revised QIs on importance and feasibility. The final list of QIs was created on the basis of panel consensus on importance.
The review identified 98 studies, from which 44 candidate QIs were created for structures (n = 12), clinical processes (n = 22), and interpersonal processes of care (n = 10). In round 1 of the Delphi survey, consensus on importance was achieved for all QIs, 5 of which were identified as requiring rephrasing. Panellists suggested 10 new QIs. In round 2, the new and revised QIs were discussed in focus groups. In round 3, the new and revised QIs achieved consensus on importance, resulting in a final list of 54 QIs (n = 43 achieving consensus on feasibility).
These QIs can assist health care providers, administrators, and policymakers in optimising the quality of pregnancy care for people with disabilities.
本研究旨在制定针对残疾人士孕期护理的质量指标（QIs）。
我们采用了兰德改良德尔菲法。首先，我们对Medline、Embase、PsycInfo和CINAHL（2004 - 2024年）进行了范围综述，以确定与残疾人士孕期护理的结构、临床过程和人际过程相关的候选质量指标。然后，在2023年6月至2024年10月期间，通过三轮德尔菲研究对质量指标草案进行验证，专家小组由17名孕期护理提供者和10名残疾产妇组成。在第一轮中，小组成员在一项调查中对质量指标草案的重要性和可行性进行评分。确定了新的质量指标和需要重新措辞的质量指标。在第二轮中，在焦点小组中对质量指标进行了讨论和完善。在第三轮中，小组成员对新的和修订后的质量指标的重要性和可行性进行评分。最终的质量指标清单是根据小组在重要性方面的共识创建的。
该综述确定了98项研究，从中为结构（n = 12）、临床过程（n = 22）和护理人际过程（n = 10）创建了44项候选质量指标。在德尔菲调查的第一轮中，所有质量指标在重要性方面达成了共识，其中5项被确定需要重新措辞。小组成员提出了10项新的质量指标。在第二轮中，在焦点小组中讨论了新的和修订后的质量指标。在第三轮中，新的和修订后的质量指标在重要性方面达成了共识，最终形成了一份包含54项质量指标的清单（n = 43项在可行性方面达成共识）。
这些质量指标可帮助医疗保健提供者、管理人员和政策制定者优化残疾人士孕期护理的质量。
