@文章{信息:doi/10.2196/37725，作者=“Depla, Anne Louise和lamin -de Ruiter, Marije和Laureij, Lyzette T和Ernst-Smelt, Hiske E和Hazelzet, Jan A和Franx, Arie和Bekker, Mireille N”，标题=“围产期护理中患者报告的结果和经验措施指导临床实践:前瞻性观察性研究”，期刊=“J医学互联网研究”，年=“2022”，月=“7月”，日=“5”，卷=“24”，数=“7”，页=“e37725”，关键词=“围产期护理;patient-reported结果;patient-reported经验;以患者为中心的结果测量;基于价值的保健;共同决策;个性化护理;背景:国际健康结局测量联盟已经发布了一套以患者为中心的妊娠和分娩结局测量(PCB集)，包括患者报告结局测量(PROMs)和患者报告体验测量(PREMs)。为了建立基于价值的妊娠和分娩护理，荷兰实施了PCB集，使用患者层面的结果进行共享决策，并在总体层面上进行质量改进。目的:本研究旨在报告在临床实践中实施PCB组的首个结果、经验和实践见解。 Methods: In total, 7 obstetric care networks across the Netherlands, each consisting of 1 or 2 hospitals and multiple community midwifery practices (ranging in number from 2 to 18), implemented the PROM and PREM domains of the PCB set as part of clinical routine. This observational study included all women participating in the clinical project. PROMs and PREMs were assessed with questionnaires at 5 time points: 2 during pregnancy and 3 post partum. Clinical threshold values (alerts) supported care professionals interpreting the answers, indicating possibly alarming outcomes per domain. Data collection took place from February 2020 to September 2021. Data analysis included missing (pattern) analysis, sum scores, alert rates, and sensitivity analysis. Results: In total, 1923 questionnaires were collected across the 5 time points: 816 (42.43{\%}) at T1 (first trimester), 793 (41.23{\%}) at T2 (early third trimester), 125 (6.5{\%}) at T3 (maternity week), 170 (8.84{\%}) at T4 (6 weeks post partum), and 19 (1{\%}) at T5 (6 months post partum). Of these, 84{\%} (1615/1923) were filled out completely. Missing items per domain ranged from 0{\%} to 13{\%}, with the highest missing rates for depression, pain with intercourse, and experience with pain relief at birth. No notable missing patterns were found. For the PROM domains, relatively high alert rates were found both in pregnancy and post partum for incontinence (469/1798, 26.08{\%}), pain with intercourse (229/1005, 22.79{\%}), breastfeeding self-efficacy (175/765, 22.88{\%}), and mother-child bonding (122/288, 42.36{\%}). Regarding the PREM domains, the highest alert rates were found for birth experience (37/170, 21.76{\%}), shared decision-making (101/982, 10.29{\%}), and discussing pain relief ante partum (310/793, 39.09{\%}). Some domains showed very little clinical variation; for example, role of the mother and satisfaction with care. Conclusions: The PCB set is a useful tool to assess patient-reported outcomes and experiences that need to be addressed over the whole course of pregnancy and childbirth. Our results provide opportunities to improve and personalize perinatal care. Furthermore, we could propose several recommendations regarding methods and timeline of measurements based on our findings. This study supports the implementation of the PCB set in clinical practice, thereby advancing the transformation toward patient-centered, value-based health care for pregnancy and childbirth. ", issn="1438-8871", doi="10.2196/37725", url="//www.mybigtv.com/2022/7/e37725", url="https://doi.org/10.2196/37725", url="http://www.ncbi.nlm.nih.gov/pubmed/35787519" }