TY - JOUR AU - Depla, Anne Louise AU - Lamain-de Ruiter, Marije AU - Laureij, Lyzette T AU - Ernst-Smelt, Hiske E AU - Hazelzet, Jan A AU - Franx, Arie AU - Bekker, Mireille N PY - 2022 DA - 2022/7/5 TI -围产期护理患者报告的结果和经验措施指导临床实践:前瞻性观察研究JO - J医学互联网Res SP - e37725 VL - 24 IS - 7kw -围产期护理KW -患者报告的结果KW -患者报告的经验KW -以患者为中心的结果测量KW -基于价值的医疗保健KW -共享决策KW -个性化护理KW -综合护理AB -背景:国际健康结果测量联盟已经发布了一套以患者为中心的妊娠和分娩结果测量(PCB集)，包括患者报告结果测量(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。方法:荷兰共有7个产科护理网络，每个网络由1或2家医院和多个社区助产实践组成(数量从2到18个不等)，实施PCB集的PROM和PREM域作为临床常规的一部分。这项观察性研究包括参与临床项目的所有女性。在5个时间点(怀孕期间2个，产后3个)通过问卷对prom和prem进行评估。临床阈值(警报)支持护理专业人员解释答案，表明每个领域可能有警报结果。数据收集时间为2020年2月至2021年9月。 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. SN - 1438-8871 UR - //www.mybigtv.com/2022/7/e37725 UR - https://doi.org/10.2196/37725 UR - http://www.ncbi.nlm.nih.gov/pubmed/35787519 DO - 10.2196/37725 ID - info:doi/10.2196/37725 ER -