通过最终用户参与,制定脑卒中后失语症服务的质量指标和实施重点。

IF 3 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Kirstine Shrubsole, Marissa Stone, Dominique A. Cadilhac, Monique F. Kilkenny, Emma Power, Elizabeth Lynch, John E. Pierce, David A. Copland, Erin Godecke, Bridget Burton, Emily Brogan, Sarah J. Wallace
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引用次数: 0

摘要

背景:目前,卒中后失语症服务还没有一致认可的质量标准。因此,护理是否反映了最佳实践或满足了失语症患者的期望尚不得而知。我们的目标是:(1) 列出脑卒中后失语症护理的最佳实践建议清单,(2) 使其可操作化,(3) 确定其优先次序:研究分为三个阶段。在第 1 阶段,确定了具有有力证据和/或已知对有失语症生活经历的人很重要的建议。有亲身经历的人和医疗专业人员通过两轮电子德尔菲活动对每项建议的重要性进行评分。然后对建议的重要性和可行性进行排序,并使用基于图式理论的投票系统进行分析。在第 2 阶段,将第 1 阶段的入围建议转化为质量指标,以便在共识会议上进行评估和投票。在第 3 阶段,由亲身经历者和医疗专业人员通过讨论和匿名投票确定实施的优先次序:在第 1 阶段,有亲身经历者(26 人)和医疗专业人员(81 人)确定了 23 项最佳实践建议,并进行了评分。最终有 10 项建议入围。在第 2 阶段,有亲身经历者(n = 4)和医疗专业人员(n = 17)就 11 项质量指标达成了共识,涉及评估(n = 2)、信息提供(n = 3)、沟通伙伴培训(n = 3)、目标设定(n = 1)、以个人和家庭为中心的护理(n = 1)和治疗提供(n = 1)。在第 3 阶段,有亲身经历的人(n = 5)和医疗专业人员(n = 7)确定了三个实施重点:失语症评估、提供失语症友好信息和提供治疗:我们的 11 项质量指标和 3 个实施重点是实现系统、高效和以人为本的卒中后失语症服务测量和质量改进的第一步。质量指标将被纳入常规数据收集系统,并将针对实施重点制定相应策略:协议的制定参考了我们之前的研究,该研究探讨了 23 位失语症患者对最佳实践失语症服务的看法。有失语症生活经验的人士作为专家小组成员参加了我们的三次共识会议。我们得到了与失语症康复与恢复卓越研究中心(Centre for Research Excellence in Aphasia Rehabilitation and Recovery)和昆士兰失语症研究中心(Queensland Aphasia Research Centre)相关的消费者咨询网络的支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Establishing Quality Indicators and Implementation Priorities for Post-Stroke Aphasia Services Through End-User Involvement

Establishing Quality Indicators and Implementation Priorities for Post-Stroke Aphasia Services Through End-User Involvement

Background

Currently, there are no agreed quality standards for post-stroke aphasia services. Therefore, it is unknown if care reflects best practices or meets the expectations of people living with aphasia. We aimed to (1) shortlist, (2) operationalise and (3) prioritise best practice recommendations for post-stroke aphasia care.

Methods

Three phases of research were conducted. In Phase 1, recommendations with strong evidence and/or known to be important to people with lived experience of aphasia were identified. People with lived experience and health professionals rated the importance of each recommendation through a two-round e-Delphi exercise. Recommendations were then ranked for importance and feasibility and analysed using a graph theory–based voting system. In Phase 2, shortlisted recommendations from Phase 1 were converted into quality indicators for appraisal and voting in consensus meetings. In Phase 3, priorities for implementation were established by people with lived experience and health professionals following discussion and anonymous voting.

Findings

In Phase 1, 23 best practice recommendations were identified and rated by people with lived experience (n = 26) and health professionals (n = 81). Ten recommendations were shortlisted. In Phase 2, people with lived experience (n = 4) and health professionals (n = 17) reached a consensus on 11 quality indicators, relating to assessment (n = 2), information provision (n = 3), communication partner training (n = 3), goal setting (n = 1), person and family-centred care (n = 1) and provision of treatment (n = 1). In Phase 3, people with lived experience (n = 5) and health professionals (n = 7) identified three implementation priorities: assessment of aphasia, provision of aphasia-friendly information and provision of therapy.

Interpretation

Our 11 quality indicators and 3 implementation priorities are the first step to enabling systematic, efficient and person-centred measurement and quality improvement in post-stroke aphasia services. Quality indicators will be embedded in routine data collection systems, and strategies will be developed to address implementation priorities.

Patient and Public Contribution

Protocol development was informed by our previous research, which explored the perspectives of 23 people living with aphasia about best practice aphasia services. Individuals with lived experience of aphasia participated as expert panel members in our three consensus meetings. We received support from consumer advisory networks associated with the Centre for Research Excellence in Aphasia Rehabilitation and Recovery and the Queensland Aphasia Research Centre.

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来源期刊
Health Expectations
Health Expectations 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.20
自引率
9.40%
发文量
251
审稿时长
>12 weeks
期刊介绍: Health Expectations promotes critical thinking and informed debate about all aspects of patient and public involvement and engagement (PPIE) in health and social care, health policy and health services research including: • Person-centred care and quality improvement • Patients'' participation in decisions about disease prevention and management • Public perceptions of health services • Citizen involvement in health care policy making and priority-setting • Methods for monitoring and evaluating participation • Empowerment and consumerism • Patients'' role in safety and quality • Patient and public role in health services research • Co-production (researchers working with patients and the public) of research, health care and policy Health Expectations is a quarterly, peer-reviewed journal publishing original research, review articles and critical commentaries. It includes papers which clarify concepts, develop theories, and critically analyse and evaluate specific policies and practices. The Journal provides an inter-disciplinary and international forum in which researchers (including PPIE researchers) from a range of backgrounds and expertise can present their work to other researchers, policy-makers, health care professionals, managers, patients and consumer advocates.
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