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Transition of care in a Danish context: translation, cross-cultural adaptation and content validation of CTM-15 and PACT-M. 丹麦背景下的护理过渡:CTM-15 和 PACT-M 的翻译、跨文化改编和内容验证。
IF 2.7 Q3 Medicine Pub Date : 2024-06-10 DOI: 10.1186/s41687-024-00739-3
Merete Ajstrup, Caroline Trillingsgaard Mejdahl, David Høyrup Christiansen, Lene Kongsgaard Nielsen

Background: Transition of care from hospitalisation to home is a complex process with potential patient safety risks, especially for patients with multimorbidity. Traditionally, the quality of transition of care has been evaluated primarily through readmission rates. However, interpreting the readmission rates presents challenges, and readmission rates fail to capture the patient's perspective on the quality of the care transition. Insight into the patient's experience with their care or a health service can be provided through the use of patient-reported experience measures (PREMs), and the two PREMs Care Transitions Measure 15 (CTM-15) and Partners at Care Transitions Measure part 1 and 2 (PACT-M1 and PACT-M2) assess on the quality of transition of care from the patients' perspective. The aim of this study was to translate, culturally adapt, and assess content validity of CTM-15, PACT-M1, and PACT-M2 for Danish-speaking patients with multimorbidity.

Methods: A two-step approach was used for content validation, involving cognitive debriefing and interviews with patients, representing the target group, as well as quantitative data collection from healthcare professionals representing all three sectors of the Danish healthcare system. The patients were systematically interviewed regarding the aspects of content validity; comprehensibility, relevance, and comprehensiveness. The healthcare professionals assessed the relevance and comprehensiveness of each item through questionnaires, allowing the calculation of a content validity index (CVI). An item CVI ≥ 0.78 is considered good.

Results: The results of the qualitative data indicated that both CTM-15 and the PACT-M questionnaires were considered relevant, and comprehensible, and comprehensive to the target group. The CVI computed at item level determined that PACT-M1 and PACT-M2 demonstrated excellent content validity among the healthcare professionals, whereas the CVI for two items of the CTM-15 fell below the threshold value for "good".

Conclusion: The Danish versions of the PACT-M questionnaires demonstrated good content validity, and the CTM-15 demonstrated acceptable content validity based on qualitative data from patients and quantitative data from healthcare professionals. Further validation of the questionnaires, by assessing their construct validity and reliability is recommended.

背景:从住院治疗到居家护理的过渡是一个复杂的过程,存在潜在的患者安全风险,尤其是对于多病患者。传统上,护理过渡的质量主要通过再入院率进行评估。然而,对再入院率的解释是个难题,而且再入院率无法反映患者对护理过渡质量的看法。通过使用患者报告体验测量(PREMs)可以深入了解患者对其护理或医疗服务的体验,而 Care Transitions Measure 15(CTM-15)和 Partners at Care Transitions Measure part 1 and 2(PACT-M1 和 PACT-M2)这两项 PREMs 可以从患者的角度评估护理过渡的质量。本研究的目的是翻译 CTM-15、PACT-M1 和 PACT-M2,并对其进行文化适应性调整和内容有效性评估,以适用于丹麦语多病症患者:方法:采用两步法进行内容验证,包括对代表目标群体的患者进行认知汇报和访谈,以及从代表丹麦医疗保健系统所有三个部门的医疗保健专业人员处收集定量数据。就内容有效性的各个方面,即可理解性、相关性和全面性,对患者进行了系统性访谈。医疗保健专业人员通过问卷对每个项目的相关性和全面性进行评估,从而计算出内容有效性指数(CVI)。项目 CVI ≥ 0.78 即为良好:定性数据的结果表明,CTM-15 和 PACT-M 问卷都被认为与目标群体相关、可理解且全面。根据项目级别计算的 CVI 值确定,PACT-M1 和 PACT-M2 在医护专业人员中表现出极佳的内容效度,而 CTM-15 中两个项目的 CVI 值低于 "良好 "的临界值:结论:丹麦版的 PACT-M 问卷显示出良好的内容效度,而 CTM-15 则根据患者的定性数据和医护人员的定量数据显示出可接受的内容效度。建议通过评估问卷的结构效度和可靠性来进一步验证问卷。
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引用次数: 0
The achievement of pre-operative expectations in patients undergoing knee arthroplasty: a cohort study evaluating unique patient goals. 膝关节置换术患者术前期望的实现情况:一项评估患者独特目标的队列研究。
IF 2.7 Q3 Medicine Pub Date : 2024-06-06 DOI: 10.1186/s41687-024-00734-8
Sascha Karunaratne, Ian Andrew Harris, Mark Horsley, Lyndal Trevena, Michael Solomon

Background: Total knee arthroplasty (TKA) is a common procedure employed to treat end-stage osteoarthritis. While TKA is generally believed to have acceptable outcomes, many patients report pain or functional deficits not in line with their expectation following the procedure. It has been postulated that patient's pre-operative expectations regarding post-operative treatment outcomes play a significant role in satisfaction. It is therefore important to assess if the outcomes of surgery truly align with patient's individual expectations. Thus, the purpose of this study was to determine the degree to which patient expectations of TKA are achieved and the contribution of TKA to achieving patient goals one year after surgery.

Methods: A consecutive sample of 110 patients booked for total knee arthroplasty were asked to identify their most important goals to inform the Direct Questioning of Objectives Index (DQO Index, range 0 to 1) and identify their surgical goals and grade their expectation that a knee arthroplasty would achieve each goal on an 11-point scale. One year after surgery, the DQO Index was repeated to assess their current ability to achieve each pre-operative goal, and asked to estimate the contribution of their knee arthroplasty in achieving each goal. Mean differences between baseline and one year follow-up were calculated regarding the DQO Index and expected achievement of pre-operative goals.

Results: According to the DQO Index at one year, patients improved from a poor quality of life pre-operatively (mean ± standard deviation: 0.20 ± 0.18) to moderately high quality of life (mean ± standard deviation: 0.71 ± 0.21) reflecting a large improvement in ability to achieve each goal. Although achievement improved, for each goal, the patient estimates of the extent to which the knee arthroplasty had contributed to achieving the goal was lower than their initial expectation provided pre-operatively (mean difference range: 0.6 to 1.9 on an 11-point scale).

Conclusion: Patients undergoing TKA have high expectations that their surgery will address their primary goals. Despite surgery largely achieving these goals (improved pain and function), the extent to which the goals were achieved was lower than patients had expected pre-operatively.

背景:全膝关节置换术(TKA)是治疗终末期骨关节炎的常用手术。虽然人们普遍认为全膝关节置换术的疗效可以接受,但许多患者反映术后疼痛或功能障碍与他们的预期不符。据推测,患者术前对术后治疗效果的期望在满意度方面起着重要作用。因此,评估手术效果是否真正符合患者的个人期望非常重要。因此,本研究旨在确定患者对 TKA 的期望实现程度以及 TKA 对实现患者术后一年目标的贡献:方法:连续抽取了 110 名预约进行全膝关节置换术的患者,要求他们确定自己最重要的目标,以作为目标直接询问指数(DQO 指数,范围为 0 至 1)的依据,并确定自己的手术目标,按 11 分制为自己对膝关节置换术实现每个目标的期望打分。术后一年,再次进行 DQO 指数测试,以评估他们目前实现每个术前目标的能力,并要求他们估计膝关节置换术对实现每个目标的贡献。计算基线和一年随访期间 DQO 指数和预期实现术前目标的平均差异:结果:根据一年后的 DQO 指数,患者的生活质量从术前的较差(平均值±标准差:0.20±0.18)提高到了中等偏上的生活质量(平均值±标准差:0.71±0.21),这反映出患者在实现每个目标的能力方面都有很大提高。虽然每个目标的实现情况都有所改善,但患者对膝关节置换术对实现目标的贡献程度的估计低于他们术前提供的最初期望值(平均差异范围:0.6 至 1.9,11 分制):结论:接受 TKA 手术的患者对手术能实现其主要目标抱有很高的期望。尽管手术在很大程度上实现了这些目标(改善疼痛和功能),但实现目标的程度却低于患者术前的预期。
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引用次数: 0
The Swedish Stroke Self-Efficacy Questionnaire: translation and cross-cultural adaptation. 瑞典脑卒中自我效能感问卷:翻译与跨文化适应。
IF 2.7 Q3 Medicine Pub Date : 2024-06-05 DOI: 10.1186/s41687-024-00735-7
Erika Klockar, Maya Kylén, Linnea McCarthy, Lena von Koch, Catharina Gustavsson, Fiona Jones, Marie Elf

Objective: To translate and cross-culturally adapt the Stroke Self-Efficacy Questionnaire (SSEQ) from English to Swedish and to evaluate psychometric properties of the questionnaire.

Methods: A cross-sectional study design, where the translation followed a process including initial translation, synthesis, backward translation, expert committee, and pretest. Content validity was assessed using Content validity index (CVI). Psychometric assessments included floor-ceiling effects and internal consistency.

Results: Language and cultural congruence were achieved, and content validity index scores were high (0.923-1). The psychometric evaluations provided acceptable outcomes concerning internal consistency, with Cronbach's alpha scores for the total scale (0.902), the activities subscale (0.861) and the self-management subscale (0.818) respectively. Ceiling effects were evident, but no floor effects.

Conclusion: This study found the Swedish version of the SSEQ promising as a tool for assessment of self-efficacy in a Swedish stroke care setting, although further psychometric assessments are recommended in future studies.

目的将脑卒中自我效能感问卷(SSEQ)从英语翻译成瑞典语并进行跨文化改编,评估问卷的心理测量学特性:采用横断面研究设计,翻译过程包括初始翻译、合成、逆向翻译、专家委员会和预测试。内容效度采用内容效度指数(CVI)进行评估。心理测量评估包括上下限效应和内部一致性:结果:实现了语言和文化的一致性,内容效度指数得分较高(0.923-1)。心理测量评估提供了可接受的内部一致性结果,总量表(0.902)、活动分量表(0.861)和自我管理分量表(0.818)的 Cronbach's alpha 分数分别为 0.902、0.861 和 0.818。最高效应明显,但无最低效应:本研究发现瑞典语版 SSEQ 可作为瑞典卒中护理环境中自我效能感的评估工具,但建议在今后的研究中进一步进行心理测量学评估。
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引用次数: 0
Patient interpretations of patient-reported outcome measures to assess bowel urgency: qualitative interviews in ulcerative colitis. 患者对用于评估肠道紧迫性的患者报告结果指标的解释:溃疡性结肠炎定性访谈。
IF 2.7 Q3 Medicine Pub Date : 2024-05-31 DOI: 10.1186/s41687-024-00733-9
Vipul Jairath, Theresa Hunter Gibble, Richard Moses, Brittany Klooster, Leighann Litcher-Kelly, Marisa Walker, Madison C Bernstein, Kaelyn Rupinski, Megan McLafferty, Simon Travis, Marla Dubinsky

Objectives: Bowel urgency is an impactful core symptom of ulcerative colitis (UC). Patient-reported outcome (PRO) questionnaires have been developed and used to assess the patient experience of this important symptom. The objective of this paper is to present evidence from qualitative research conducted to support the use and interpretation of select PRO questionnaires to assess bowel urgency related to the UC patient experience.

Methods: Qualitative interviews were conducted with ten adults with a clinician-confirmed diagnosis of moderately to severely active UC. Interviews aimed to document patient interpretation of modified recall periods for the Urgency Numeric Rating Scale (Urgency NRS), two global assessments (i.e., the Patient Global Impression of Severity [PGIS] and Patient Global Impression of Change [PGIC]), and four items (Items 11, 16, 23, and 26) of the Inflammatory Bowel Disease Questionnaire (IBDQ), and explore the patient perspective of meaningful change on these questionnaires.

Results: Both modified Urgency NRS versions (with 7-day or 3-day recall period) were interpreted as intended by most patients (≥ 88.9%), and slightly more than half of patients (60.0%) reported that the 7-day recall period was more relevant to their bowel urgency experience. Patients reported thinking of bowel urgency (≥ 80.0%) or bowel urgency-related accidents (70.0% of patients) when interpreting the global assessments and IBDQ items. Most patients reported a 1- to 3-point change as the smallest meaningful improvement that would be meaningful on the Urgency NRS (similar to findings on other questionnaires).

Conclusion: Adults with UC can understand and respond to the Urgency NRS with modified recall periods (i.e., 7-day or 3-day), interpret the conceptual content of the PGIS, PGIC, and select IBDQ items to be inclusive of bowel urgency and bowel urgency-related accidents, and select answers representing meaningful improvements on the Urgency NRS, PGIS, PGIC, and IBDQ item response scales. These results further contribute patient-centered data to existing UC and bowel urgency research.

目的:肠紧迫感是溃疡性结肠炎(UC)的一个有影响的核心症状。患者报告结果 (PRO) 问卷已被开发并用于评估患者对这一重要症状的体验。本文旨在介绍定性研究的证据,以支持使用和解释选定的 PRO 问卷来评估与 UC 患者体验相关的肠道紧迫感:对十名经临床医生确诊为中度至重度活动性尿路感染的成人进行了定性访谈。访谈的目的是记录患者对急迫性数字评分量表(Urgency NRS)、两项总体评估(即患者对严重性的总体印象[PGIS]和患者对变化的总体印象[PGIC])以及炎症性肠病问卷(IBDQ)的四个项目(项目 11、16、23 和 26)的修改回忆期的解释,并探讨患者对这些问卷上有意义的变化的看法:结果:大多数患者(≥ 88.9%)对两种修订版急迫感 NRS(7 天或 3 天回忆期)的解释都符合预期,略多于一半的患者(60.0%)表示 7 天回忆期与他们的肠道急迫感经历更相关。在解释总体评估和 IBDQ 项目时,患者表示想到了肠紧迫感(≥ 80.0%)或肠紧迫感相关事故(70.0% 的患者)。大多数患者表示,1 到 3 分的变化是急迫感 NRS 有意义的最小改善(与其他问卷调查结果类似):结论:成人 UC 患者可以理解并回答急迫性 NRS,并修改回忆期(即 7 天或 3 天),解释 PGIS、PGIC 和部分 IBDQ 项目的概念内容,使其包括肠急迫性和与肠急迫性相关的意外,并在急迫性 NRS、PGIS、PGIC 和 IBDQ 项目反应量表上选择代表有意义改善的答案。这些结果进一步为现有的 UC 和肠紧迫性研究提供了以患者为中心的数据。
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引用次数: 0
Crosswalk between the PROMIS physical function CAT and PROMIS upper extremity CAT v1.2 in a hand surgery population. 手外科人群中 PROMIS 身体功能 CAT 与 PROMIS 上肢功能 CAT v1.2 之间的交叉对比。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-05-30 DOI: 10.1186/s41687-024-00736-6
Miranda J Rogers, Joshua R Daryoush, Chong Zhang, Amy Cizik, Angela P Presson, Nikolas H Kazmers

Background: There is no gold standard patient-reported outcome measure (PROM) in hand surgery. As a result, a diverse array of PROM instruments have been utilized across centers over time. Lack of score interchangeability limits the ability to compare or conglomerate scores when new instruments are introduced. Our aim was to develop a linkage for the PROMIS UE CAT v1.2 and PROMIS PF CAT scores and develop crosswalk tables for interconversion between these PROMs.

Methods: Retrospective review was conducted to identify adult (≥ 18y) patients seen by orthopaedic hand surgeons at a single academic tertiary care hospital who had completed PROMIS UE CAT v1.2 and PROMIS PF CAT score at the same visit. For those with multiple visits, only one randomly selected visit was included in the analyses. Pearson's correlation was calculated to determine the linear relationship between the scores. Linkage from PF to UE was performed utilizing several commonly utilized equating models (identity, mean, linear, equipercentile and circle-arc methods). The performance of the models was assessed using intraclass correlation (ICC) between observed PROMIS UE CAT v1.2 and estimated PROMIS UE CAT v1.2 scores generated using the model as well as Root Mean Square Error (RMSE). The model chosen as the 'best' was further assessed for population invariance using root expected mean squared difference (REMSD) where < 0.08 were considered good.

Results: Of 10,081 included patients, mean age was 48.3 (SD = 17.0), and 54% were female (5,477/10,081). Mean UE CAT v1.2 and PF CAT scores were 37 (SD = 9.8) and 46 (SD = 10.0), respectively. There was a strong correlation between the scores (Pearson correlation r = 0.70). All methods performed acceptably (ICC ≥ 0.66 and RMSE < = 7.52 for all). The equipercentile method had the highest ICC (ICC = 0.70 (95% CI 0.69-0.71)) while the mean and circle arc methods had the lowest RMSE. The circle arc method is the most reliable with the smallest standard error and has satisfactory population invariance across age group (REMSD 0.065) and sex (REMSD 0.036).

Conclusions: Crosswalk tables to be used for bidirectional conversion between scores were created.

Level of evidence: III.

背景:手外科没有金标准的患者报告结果测量(PROM)。因此,随着时间的推移,各中心使用了各种不同的 PROM 工具。由于缺乏评分互换性,因此在引入新工具时,比较或合并评分的能力受到限制。我们的目的是为 PROMIS UE CAT v1.2 和 PROMIS PF CAT 评分建立联系,并为这些 PROMs 之间的相互转换建立交叉表:方法:对一家学术性三甲医院的手部整形外科医生所诊治的成年(≥ 18 岁)患者进行回顾性审查,这些患者在同一次就诊时完成了 PROMIS UE CAT v1.2 和 PROMIS PF CAT 评分。对于多次就诊的患者,仅随机抽取一次就诊纳入分析。计算皮尔逊相关性以确定得分之间的线性关系。利用几种常用的等值模型(同一性、平均值、线性、等百分位数和圆弧法)将 PF 与 UE 联系起来。使用观察到的 PROMIS UE CAT v1.2 和使用模型生成的估计 PROMIS UE CAT v1.2 分数之间的类内相关性 (ICC) 以及均方根误差 (RMSE) 来评估模型的性能。选定的 "最佳 "模型使用期望均方差根值(REMSD)进一步评估其人群不变性(见结果):在纳入的 10,081 名患者中,平均年龄为 48.3 岁(SD = 17.0),54% 为女性(5,477/10,081)。UE CAT v1.2 和 PF CAT 的平均得分分别为 37 分(标准差 = 9.8)和 46 分(标准差 = 10.0)。得分之间有很强的相关性(Pearson correlation r = 0.70)。所有方法的性能均可接受(ICC ≥ 0.66 和 RMSE 结论):建立了用于分数之间双向转换的交叉表:证据等级:III。
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引用次数: 0
Quality of life in individuals with neurofibromatosis type 1 associated cutaneous neurofibromas: validation of the Dutch cNF-Skindex. 1 型神经纤维瘤相关皮肤神经纤维瘤患者的生活质量:荷兰 cNF-Skindex 验证。
IF 2.7 Q3 Medicine Pub Date : 2024-05-29 DOI: 10.1186/s41687-024-00732-w
Britt A E Dhaenens, Sarah A van Dijk, Laura Fertitta, Walter Taal, Pierre Wolkenstein, Rianne Oostenbrink

Background: Almost all patients with Neurofibromatosis type 1 (NF1) develop cutaneous neurofibroma (cNF), benign dermal tumours that have a large impact on the patient's Quality of Life (QoL). The French cNF-Skindex is the first questionnaire to specifically assess cNF-related QoL in patients with NF1. We aimed to adapt and validate a Dutch version of the cNF-Skindex.

Methods: The questionnaire was translated using forward and backwards translation, and subsequently administered to a sample of 59 patients on two separate occasions. Feasibility was evaluated by the presence of floor/ceiling effects. Reliability was assessed by evaluating internal consistency and test-retest reliability, by calculating Cronbach's alpha and Spearman's rank correlation coefficients. The EQ-5D-5L and SF-36 were used to evaluate convergent validity, using Spearman's rank correlation coefficients. An exploratory factor analysis was performed to study the data's internal structure. Multivariable linear regression was used to model the relationship between patient characteristics and the cNF-Skindex.

Results: The Dutch cNF-Skindex demonstrated excellent feasibility and reliability (Cronbach's alpha 0.96, test-retest correlation coefficient 0.88). Convergent validity was confirmed for the EQ-5D-5L and relevant SF-36 scales. All items and subdomains from the original questionnaire were confirmed following exploratory factor analysis. The patient characteristics included in the multivariable linear regression were not significantly associated with the cNF-Skindex score.

Conclusions: The Dutch cNF-Skindex displayed excellent psychometric properties, enabling use in the Netherlands.

背景:几乎所有 1 型神经纤维瘤病 (NF1) 患者都会患皮肤神经纤维瘤 (cNF),这种皮肤良性肿瘤对患者的生活质量 (QoL) 有很大影响。法国的 cNF-Skindex 是第一份专门评估 NF1 患者与 cNF 相关的 QoL 的问卷。我们旨在改编并验证荷兰版的 cNF-Skindex 调查问卷:采用正译和反译的方法翻译了该问卷,随后在两个不同的场合对 59 名患者进行了抽样调查。可行性通过是否存在地板/天花板效应进行评估。通过计算 Cronbach's alpha 和 Spearman's rank 相关系数来评估内部一致性和测试-再测可靠性。EQ-5D-5L 和 SF-36 采用斯皮尔曼等级相关系数来评估收敛效度。为研究数据的内部结构,进行了探索性因子分析。多变量线性回归用于模拟患者特征与 cNF-Skindex 之间的关系:结果:荷兰 cNF-Skindex 具有极佳的可行性和可靠性(Cronbach's alpha 0.96,测试-重复相关系数 0.88)。EQ-5D-5L 和相关 SF-36 量表的收敛有效性得到了证实。经过探索性因子分析,确认了原始问卷中的所有项目和子域。多变量线性回归中包含的患者特征与 cNF-Skindex 评分无明显关联:荷兰 cNF-Skindex 具有良好的心理测量特性,可在荷兰使用。
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引用次数: 0
Correction: Impact of tardive dyskinesia on patients and caregivers: a survey of caregivers in the United States. 更正:迟发性运动障碍对患者和护理人员的影响:美国护理人员调查。
IF 2.7 Q3 Medicine Pub Date : 2024-05-17 DOI: 10.1186/s41687-024-00728-6
Rakesh Jain, Rajeev Ayyagari, Debbie Goldschmidt, Mo Zhou, Stacy Finkbeiner, Sam Leo
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引用次数: 0
Correction: Impact of tardive dyskinesia on patients and caregivers: a survey of caregivers in the United States. 更正:迟发性运动障碍对患者和护理人员的影响:美国护理人员调查。
IF 2.7 Q3 Medicine Pub Date : 2024-05-17 DOI: 10.1186/s41687-024-00728-6
Rakesh Jain, R. Ayyagari, D. Goldschmidt, Mo Zhou, Stacy Finkbeiner, S. Leo
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引用次数: 0
Understanding reliability of the observer-reported communication ability measure within Angelman syndrome through the lens of generalizability theory. 从可推广性理论的角度了解安杰尔曼综合症中观察者报告的沟通能力测量的可靠性。
IF 2.7 Q3 Medicine Pub Date : 2024-05-14 DOI: 10.1186/s41687-024-00725-9
Dandan Chen, Christina K Zigler, Li Lin, Nicole Lucas, Molly McFatrich, Jennifer Panagoulias, Allyson Berent, Bryce B Reeve

Aims: Caregivers rate improved communication ability as one of the most desired outcomes for successful interventions for individuals with Angelman syndrome (AS). When measuring communication ability in clinical trials, the reliability of such measures is critical for detecting significant changes over time. This study examined the reliability of the Observed-Reported Communication Ability (ORCA) measure completed by caregivers of individuals with AS.

Methods: The ORCA measure was completed by 249 caregivers with 170 caregivers completing the ORCA measure again after 5-12 days. Generalizability theory was used to examine the following sources of measurement error in ORCA scores: concepts, subdomains, assessment points, and the interactions among those facets and the object of measurement: communication ability. Three generalizability studies were conducted to understand the reliability of the ORCA measure for different measurement designs. Decision studies were carried out to demonstrate the optimization of measurement procedures of the ORCA measure.

Results: G and Phi coefficients of the original measurement design exceeded the 0.80 threshold considered sufficiently reliable to make relative and absolute decisions about the communication ability of individuals with AS based on their caregivers' observed scores. The optimization procedures indicated that increasing the number of communication concepts and/or assessment points leads to more reliable estimates of communication.

Conclusion: The ORCA measure was able to reliably distinguish different levels of communication ability among individuals with AS. Multiple assessment points and or more concepts would provide more precise estimates of an individual's communication ability but at the cost of survey fatigue.

目的:护理人员认为,提高交流能力是成功干预安杰曼综合症(AS)患者的最理想结果之一。在临床试验中测量交流能力时,此类测量的可靠性对于检测随时间发生的显著变化至关重要。本研究考察了由 AS 患者的照顾者完成的 "观察-报告交流能力"(ORCA)测量的可靠性:249名护理人员完成了ORCA测量,170名护理人员在5-12天后再次完成了ORCA测量。普适性理论用于研究 ORCA 评分测量误差的以下来源:概念、子域、评估点以及这些方面与测量对象(沟通能力)之间的相互作用。为了了解不同测量设计下 ORCA 测量的可靠性,我们进行了三项可推广性研究。此外,还进行了决策研究,以证明 ORCA 测量程序的优化:结果:原始测量设计的G系数和Phi系数超过了0.80的临界值,这被认为是足够可靠的,可以根据护理人员的观察分数对强直性脊柱炎患者的沟通能力做出相对和绝对的判断。优化程序表明,增加沟通概念和/或评估点的数量可使对沟通能力的估计更加可靠:ORCA测量能够可靠地区分AS患者的不同沟通能力水平。多个评估点或更多的概念可以更精确地估计个体的沟通能力,但代价是调查疲劳。
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引用次数: 0
Development and validation of clinical implementation methods for patient-reported outcomes in Japanese multi-center palliative care units. 日本多中心姑息治疗病房患者报告结果的临床实施方法的开发与验证。
IF 2.4 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-05-14 DOI: 10.1186/s41687-024-00730-y
Nao Ito, Azusa Sato, Kana Takeuchi, Tomoko Shigeno, Hiroko Sasaki, Maho Aoyama, Mitsunori Miyashita

Background: Patient-Reported Outcomes (PROs) are recommended for use in clinical oncology. However, they are not routinely used in professional palliative care practices in Japan. The reasons include both patient and healthcare provider factors and the implementation of PROs. This study aimed to develop and validate clinical implementation methods for PROs in Japanese palliative care units.

Methods: The Consolidated Framework for Implementation Research (CFIR) was conducted with four palliative care units in Japan. The study was conducted in six steps: unit assessment, development and implementation of a PRO implementation plan, PRO post-implementation survey and analysis of its utilization, a review of the PRO implementation process, creation of a PRO implementation method in a palliative care unit, and use and verification of the implementation method. Steps 1-5 were the development phase, and step 6 was the verification phase.

Results: Interviews were conducted with healthcare providers prior to PRO implementation. Intervention characteristics, patient needs in the palliative care unit, and factors related to the organization were identified as barriers. The implementation plan was developed, and the core members were selected. The implementation procedures were created in the above mentioned steps. PROs were used in the palliative care units. The same was true in the validation phase.

Conclusions: This study guided PROs in specialized palliative care unit in a clinical setting. The method was developed and validated for the implementation of PROs in the palliative care unit. In the PRO implementation process, it was important to assess the unit, address the barriers to implementation, and reduce the burden on healthcare providers. Furthermore, healthcare providers had to be supported by the champion, a person responsible for the implementation of PROs in the palliative care unit.

背景:患者报告结果(PROs)被推荐用于临床肿瘤学。然而,在日本,专业姑息治疗实践中并未常规使用这些指标。究其原因,既有患者和医疗服务提供者的因素,也有 PROs 的实施因素。本研究旨在开发和验证PROs在日本姑息治疗单位的临床实施方法:方法:在日本四家姑息治疗机构开展了实施研究综合框架(CFIR)研究。研究分六个步骤进行:单位评估、制定和实施 PRO 实施计划、PRO 实施后调查及其使用分析、PRO 实施过程回顾、在姑息治疗单位创建 PRO 实施方法,以及实施方法的使用和验证。第 1-5 步为开发阶段,第 6 步为验证阶段:结果:在实施 PRO 之前,对医疗服务提供者进行了访谈。干预特点、姑息关怀病房患者的需求以及与组织相关的因素被确定为障碍。制定了实施计划,并选定了核心成员。在上述步骤中制定了实施程序。在姑息关怀病房中使用了PROs。在验证阶段也是如此:本研究在临床环境中指导了专业姑息关怀病房的PROs。该方法是为在姑息关怀病房实施PRO而开发和验证的。在PRO的实施过程中,重要的是要对科室进行评估,解决实施过程中的障碍,减轻医护人员的负担。此外,医疗服务提供者必须得到支持者的支持,即负责在姑息关怀病房实施PROs的人员。
{"title":"Development and validation of clinical implementation methods for patient-reported outcomes in Japanese multi-center palliative care units.","authors":"Nao Ito, Azusa Sato, Kana Takeuchi, Tomoko Shigeno, Hiroko Sasaki, Maho Aoyama, Mitsunori Miyashita","doi":"10.1186/s41687-024-00730-y","DOIUrl":"10.1186/s41687-024-00730-y","url":null,"abstract":"<p><strong>Background: </strong>Patient-Reported Outcomes (PROs) are recommended for use in clinical oncology. However, they are not routinely used in professional palliative care practices in Japan. The reasons include both patient and healthcare provider factors and the implementation of PROs. This study aimed to develop and validate clinical implementation methods for PROs in Japanese palliative care units.</p><p><strong>Methods: </strong>The Consolidated Framework for Implementation Research (CFIR) was conducted with four palliative care units in Japan. The study was conducted in six steps: unit assessment, development and implementation of a PRO implementation plan, PRO post-implementation survey and analysis of its utilization, a review of the PRO implementation process, creation of a PRO implementation method in a palliative care unit, and use and verification of the implementation method. Steps 1-5 were the development phase, and step 6 was the verification phase.</p><p><strong>Results: </strong>Interviews were conducted with healthcare providers prior to PRO implementation. Intervention characteristics, patient needs in the palliative care unit, and factors related to the organization were identified as barriers. The implementation plan was developed, and the core members were selected. The implementation procedures were created in the above mentioned steps. PROs were used in the palliative care units. The same was true in the validation phase.</p><p><strong>Conclusions: </strong>This study guided PROs in specialized palliative care unit in a clinical setting. The method was developed and validated for the implementation of PROs in the palliative care unit. In the PRO implementation process, it was important to assess the unit, address the barriers to implementation, and reduce the burden on healthcare providers. Furthermore, healthcare providers had to be supported by the champion, a person responsible for the implementation of PROs in the palliative care unit.</p>","PeriodicalId":36660,"journal":{"name":"Journal of Patient-Reported Outcomes","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11093964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Journal of Patient-Reported Outcomes
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