In Pursuit of Patient-Centred Outcomes: A Qualitative Evaluation of the ‘Measure Yourself Medical Outcome Profile’
In Pursuit of Patient-Centred Outcomes: A Qualitative Evaluation of the ‘Measure Yourself Medical Outcome Profile’
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追求以患者为中心的结果：“自我衡量医疗结果概况”的定性评估
DOI：
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发表时间：
2000
影响因子：
2.4
通讯作者：
N. Britten
中科院分区：
文献类型：
--
作者：
C. Paterson;N. Britten
目的：为了确定患者产生的结果衡量标准--“测量自己的医疗结果概况”(MYMOP)--反映患者认为最重要的会诊结果的能力，这是从定性访谈中得出的。方法：定性研究，采用恒定比较法，分析半结构式访谈结果，并与MYMOP问卷结果进行比较。以变量为导向的分析被用来发展主题，以案例为导向的分析被用来从访谈中制定被称为小插曲的叙事摘要。MYMOP问卷由受访者(n=20)填写，在四个月的时间里，最少填写两次，最多填写九次。分数显示在个人MYMOP图表上。对于每个个体，将MYMOP测量的结果与定性访谈的结果数据进行比较。受访者参加了各种初级保健补充医生的培训。结果：人们描述的治疗效果包括五个主题：症状的减少；残疾的减少；减少或避免药物治疗；获得控制和改善应对技能；通过患者与医生的关系获得支持和希望。这些小插图展示了个人如何识别和评价这些不同的影响，并在评估治疗的总体好处时对其进行权衡。他们的MYMOP图表能够比其他图表更好地衡量一些影响。结论：用MYMOP量化的治疗效果与大多数患者在访谈中描述的一致，但MYMOP发现了一些重要的局限性，特别是低估了这一患者组避免用药或减少用药的重要性。这一方面在大多数成果问卷中都缺乏，并已纳入新版本的多年期项目。这项研究还表明，定性访谈数据有助于评估结果问卷的能力，以衡量特定患者群体认为最重要的治疗效果。
Objectives: To ascertain the ability of a patient-generated outcome measure, the ‘Measure Yourself Medical Outcome Profile’ (MYMOP), to reflect the outcomes of consultations which patients consider are most important, as derived from qualitative interviews. Methods: A qualitative study using a constant comparative method to analyse semistructured interviews which were then compared with the results of MYMOP questionnaires. A variable-orientated analysis was used to develop themes and a case-orientated analysis was used to develop narrative summaries called vignettes from the interviews. The MYMOP questionnaire was completed by the interviewees (n= 20), a minimum of twice and a maximum of nine times over a four-month period. The scores were displayed on individual MYMOP charts. For each individual, the outcome as measured by MYMOP was compared with the outcome data from the qualitative interviews. The interviewees were attending a variety of complementary practitioners in primary care. Results: The treatment effects which people described were encompassed by five themes: reduction in symptoms; reduction in disability; reduction in, or avoidance of, medication; gaining control and improving coping skills; and securing support and hope through the patient—practitioner relationship. The vignettes demonstrated how individuals identified and valued these various effects and weighed them up in evaluating the overall benefit of the treatment. Their MYMOP charts were able to measure some effects better than others. Conclusions: The treatment effects, as quantified using MYMOP, accorded with those described by most patients at interview, but some important limitations were identified with MYMOP, particularly an underplaying of the importance of medication avoidance or medication reduction in this patient group. This dimension is lacking in most outcome questionnaires and has been included in a new version of MYMOP. This study also showed that qualitative interview data can help in evaluating the ability of outcome questionnaires to measure the treatment effects that particular patient groups consider most important.