One Size Doesn't Fit All: Clinician Perspectives on Using Health-Related Quality of Life for Service Evaluation in Australian Community Health

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-07-23 DOI:10.1111/jep.70204

Laura Ryan, Caitlin Brandenburg, Karen Spence, Jillian Williams, EJ Milne, Sharon Leslie, Matthew Percival, Letisha Living, Paula Rankmore, Laetitia Hattingh

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引用次数: 0

Abstract

Rationale

Health-related quality of life (HRQoL) offers a framework for assessing the impact of health conditions and treatments on a patient's overall well-being. It also holds the potential to evaluate the effectiveness of hospital and health services. However, this approach lacks evidence to fully support its widespread adoption.

Aims and Objectives

To explore current HRQoL practices and clinician attitudes toward standardising HRQoL instruments for service evaluation across a diverse range of in-scope community health services.

Methods

Semi-structured interviews were conducted with 20 senior clinicians from community health services. An interview guide was used, and interviews were recorded, transcribed, and analysed using content analysis to identify key themes and insights.

Results

The average interview time was 20.1 min (SD = 4.6). While some HRQoL instruments were used, others had been discontinued due to limitations in relevance or effectiveness. Informal HRQoL assessments were commonly used alongside other instruments to gather broader insight into patient well-being. There was support for a holistic approach to service evaluation, emphasising comprehensive, contextually relevant assessments that are user-friendly and evidence-based. However, participants also raised several limitations to using HRQoL for service evaluation, such as the potential for misleading information, implementation difficulties, and risks to patient care. Participants identified 33 potential domains to be measured to demonstrate service success, with the most frequently cited being mental health, social connections, ability to perform daily activities, leisure pursuits, mobility and feeling supported.

Conclusion

Findings underscore the need for balanced and meaningful assessment instruments that accurately capture the full scope of patient well-being for evaluation purposes. No single HRQoL assessment instrument is likely to address the needs of services providing care for patients with complex and varied conditions. It is essential to use assessment instruments tailored to individual patient cohorts, resonating with clinicians and patients.

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一个尺寸不适合所有：临床医生的观点使用健康相关的生活质量服务评估在澳大利亚社区卫生

基本原理与健康有关的生活质量（HRQoL）为评估健康状况和治疗对患者整体福祉的影响提供了一个框架。它还具有评估医院和保健服务有效性的潜力。然而，这种方法缺乏充分支持其广泛采用的证据。目的和目的探讨当前的HRQoL实践和临床医生对标准化HRQoL工具的态度，以便在不同范围的社区卫生服务中进行服务评估。方法对20名社区卫生服务机构的高级临床医生进行半结构化访谈。使用了采访指南，并使用内容分析对采访进行记录、转录和分析，以确定关键主题和见解。结果平均访谈时间为20.1 min （SD = 4.6）。虽然使用了一些HRQoL工具，但由于相关性或有效性的限制，其他工具已停止使用。非正式HRQoL评估通常与其他工具一起使用，以更广泛地了解患者的健康状况。会议支持对服务评价采取整体办法，强调对用户友好和以证据为基础的全面、与具体情况相关的评估。然而，参与者也提出了使用HRQoL进行服务评估的几个限制，例如可能产生误导性信息、实施困难和对患者护理的风险。参与者确定了33个潜在的衡量服务成功的领域，其中最常被提及的是心理健康、社会关系、日常活动能力、休闲追求、流动性和感觉被支持。结论：研究结果强调需要平衡和有意义的评估工具，以准确捕捉患者福祉的全部范围进行评估。没有一种单一的HRQoL评估工具可能满足为复杂和多种疾病患者提供护理的服务机构的需求。必须使用针对个别患者群体的评估工具，与临床医生和患者产生共鸣。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.