门诊姑息治疗的电子会诊前议程设置问卷对患者、护理伙伴和临床医生来说是可行和可接受的:一种混合方法评估。

IF 3.6 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Palliative Medicine Pub Date : 2025-04-01 Epub Date: 2025-02-25 DOI:10.1177/02692163251321327
Matthew M Wilson, Kathleen Broglio, Maxwell T Vergo, Amber E Barnato, Amelia M Cullinan, Julie R Doherty, Joel R King, Anna Marie Devito, Anne B Holmes, Jennifer J Hinson, Kimberley R Holt, Megan M Holthoff, Emily G Kobin, Alaina R Legere, Eugene C Nelson, Elizabeth A O'Donnell, Catherine H Saunders, Stephanie C Tomlin, Kathryn B Kirkland, Aricca D Van Citters
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引用次数: 0

摘要

背景:为重症患者提供以患者为中心的医疗保健,医疗团队必须从患者和护理伙伴那里获得需求、目标、偏好和价值观。目的:描述为患者和护理伙伴在门诊姑息治疗就诊前确定这些主题的电子访前议程设置问卷的可行性和可接受性。设计:并行混合方法形成性评价问卷的可行性和可接受性。我们从电子健康记录中提取问卷回答和患者特征,并发送匿名访后患者体验调查。研究人员对参与者的半结构化访谈进行了主题分析。环境/参与者:2021年6月至2023年3月期间,患者参与者在美国东北部农村的三级学术医疗中心的独立姑息治疗诊所拥有活跃的患者门户账户和门诊就诊。诊所工作人员包括医生、执业护士、社工、护士和排班秘书。大多数访问是通过视频或电话进行的。结果:访前问卷完成率为50%(4204次访前问卷中有2107份)。完成访后调查(随访859次)的患者报告访前问卷易于完成(75%),并有助于他们与临床医生的对话(79%)。相信他们的临床医生审查了他们的反应的患者(82%)比没有审查的患者(59%)对共同决策的评价更高。对5名患者、2名护理伙伴和7名临床医生进行的半结构化访谈确定了四个主题:问卷调查使患者参与会诊前计划,将护理伙伴纳入护理团队,促进护理伙伴的护理,并提高感知效率和护理质量。结论:电子访前问卷在姑息治疗门诊访视中是可行和可接受的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An electronic pre-visit agenda-setting questionnaire in ambulatory palliative care is feasible and acceptable to patients, care partners, and clinicians: A mixed methods evaluation.

Background: To provide patient-centered healthcare for people with serious illness, healthcare teams must elicit needs, goals, preferences, and values from patients and care partners.

Aim: Describe feasibility and acceptability of an electronic pre-visit agenda-setting questionnaire for patients and care partners to identify these topics before ambulatory palliative care visits.

Design: Concurrent mixed-methods formative evaluation of questionnaire feasibility and acceptability. We extracted questionnaire responses and patient characteristics from electronic health records and sent anonymous post-visit patient experience surveys. Researchers conducted thematic analysis on semi-structured interviews with participants.

Setting/participants: Patient participants had an active patient portal account and ambulatory visit at a free-standing palliative care clinic in a tertiary academic medical center in rural Northeastern United States between June 2021 and March 2023. Clinic staff included physicians, nurse practitioner, social worker, nurses, and scheduling secretary. Most visits were conducted via video or telephone.

Results: Completion rate was 50% for pre-visit questionnaires (2107 of 4204 visits). Patients completing post-visit surveys (following 859 visits) reported the pre-visit questionnaire was easy to complete (75%) and helped their conversations with clinicians (79%). Patients who believed their clinician reviewed their responses rated shared decision-making higher (82%) than those who did not (59%). Semi-structured interviews with five patients, two care partners, and seven clinicians identified four themes: the questionnaire engages patients in pre-visit planning, incorporates care partners into the care team, facilitates care for the care partner, and improves perceived efficiency and care quality.

Conclusions: An electronic pre-visit questionnaire was feasible and acceptable in ambulatory palliative care visits.

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来源期刊
Palliative Medicine
Palliative Medicine 医学-公共卫生、环境卫生与职业卫生
CiteScore
7.60
自引率
9.10%
发文量
125
审稿时长
6-12 weeks
期刊介绍: Palliative Medicine is a highly ranked, peer reviewed scholarly journal dedicated to improving knowledge and clinical practice in the palliative care of patients with far advanced disease. This outstanding journal features editorials, original papers, review articles, case reports, correspondence and book reviews. Essential reading for all members of the palliative care team. This journal is a member of the Committee on Publication Ethics (COPE).
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