Methicillin-Resistant Staphylococcus aureus Eradication and Decolonization in Children Study (Part 2): Patient- and Parent-Centered Outcomes of Decolonization.
Methicillin-Resistant Staphylococcus aureus Eradication and Decolonization in Children Study (Part 2): Patient- and Parent-Centered Outcomes of Decolonization.
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DOI：
10.2196/14973
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发表时间：
2020-05-20
影响因子：
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通讯作者：
Musey, Paul I
中科院分区：
文献类型：
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作者：
Moore, Courtney M;Wiehe, Sarah E;Musey, Paul I
背景：由社区获得性耐甲氧西林金黄色葡萄球菌 (MRSA) 引起的皮肤和软组织感染 (SSTI) 可导致许多已知的重大医疗后果，包括住院、切开引流 (I&D) 等外科手术，以及需要进行去定植手术以清除皮肤和鼻子中的细菌并防止复发感染。很少有研究来了解与成功治疗 MRSA 感染相关的以患者和护理人员为中心的结果。 目的：本研究旨在揭示对患者及其父母重要的 MRSA 去定植结果，以便创建一套用于儿童 MRSA 根除和去定植 (MEDiC) 研究的原型措施。 方法：与 5 名青少年（年龄10-18 岁）经历过 I&D 程序，以及 11 位经历过 I&D 程序的孩子的家长。该研讨会探讨了患者和家属在皮肤感染方面的经历，以揭示以患者为中心的 MRSA 治疗结果。研究团队分析了研讨会期间创建的音频和工件，并针对主题相似性进行了编码。最终主题代表了 MEDiC 比较有效性试验中要衡量的以患者为中心的结果领域。结果：研讨会确定了对患者及其父母重要的 9 个结果：MRSA 爆发减少、情绪健康改善、自我认知改善、社会耻辱减少、自由时间增加、对自由时间的控制增强、缺课天数减少、身体疼痛和不适减少以及经济负担减轻。结论：这项研究代表了一种创新的 HCD 方法，让有生活经验的患者和家庭参与其中MRSA SSTI 参与研究设计和试验开发，以确定有意义的以患者为中心的结果。我们能够确定 9 个主要的反复出现的主题。这些主题用于制定 MEDiC 的主要和次要结局指标，MEDiC 是一项前瞻性招募的比较有效性试验。试验注册：ClinicalTrials.gov NCT02127658； https://clinicaltrials.gov/ct2/show/NCT02127658。
BACKGROUND: Skin and soft tissue infections (SSTIs) due to community-acquired methicillin-resistant Staphylococcus aureus (MRSA) can lead to a number of significant known medical outcomes including hospitalization, surgical procedures such as incision and drainage (I&D), and the need for decolonization procedures to remove the bacteria from the skin and nose and prevent recurrent infection. Little research has been done to understand patient and caregiver-centered outcomes associated with the successful treatment of MRSA infection.OBJECTIVE: This study aimed to uncover MRSA decolonization outcomes that are important to patients and their parents in order to create a set of prototype measures for use in the MRSA Eradication and Decolonization in Children (MEDiC) study.METHODS: A 4-hour, human-centered design (HCD) workshop was held with 5 adolescents (aged 10-18 years) who had experienced an I&D procedure and 11 parents of children who had experienced an I&D procedure. The workshop explored the patient and family experience with skin infection to uncover patient-centered outcomes of MRSA treatment. The research team analyzed the audio and artifacts created during the workshop and coded for thematic similarity. The final themes represent patient-centered outcome domains to be measured in the MEDiC comparative effectiveness trial.RESULTS: The workshop identified 9 outcomes of importance to patients and their parents: fewer MRSA outbreaks, improved emotional health, improved self-perception, decreased social stigma, increased amount of free time, increased control over free time, fewer days of school or work missed, decreased physical pain and discomfort, and decreased financial burden.CONCLUSIONS: This study represents an innovative HCD approach to engaging patients and families with lived experience with MRSA SSTIs in the study design and trial development to determine meaningful patient-centered outcomes. We were able to identify 9 major recurrent themes. These themes were used to develop the primary and secondary outcome measures for MEDiC, a prospectively enrolling comparative effectiveness trial.TRIAL REGISTRATION: ClinicalTrials.gov NCT02127658; https://clinicaltrials.gov/ct2/show/NCT02127658.