"Unspoken Questions": A Qualitative Study of Rheumatologists' Perspectives on the Clinical Implementation of Patient-reported Outcome Measures.
"Unspoken Questions": A Qualitative Study of Rheumatologists' Perspectives on the Clinical Implementation of Patient-reported Outcome Measures.
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“不言而喻的问题”：风湿病学家对患者报告结果指标临床实施的观点的定性研究。
DOI：
10.3899/jrheum.200232
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发表时间：
2020-12-01
期刊：
影响因子：
--
通讯作者：
LeClair A
中科院分区：
文献类型：
--
作者：
Kasturi S;Wong JB;Mandl LA;McAlindon TE;LeClair A
确定风湿病学家对临床实施患者报告结果指标（PROM）的障碍和促进者的看法（PROM）
半结构化的访谈是对临床风湿病学家进行的，对访谈进行了录音和转录。
在两个城市学术医疗中心，有15名参加风湿病学家，8名女性（53％）和7名男性（47％），其中位数为15年（5至43个）。护理，突出物理上的买入和文化变化，因为它们超出了后勤方面的重大挑战。对患者最有趣的领域也认识到临床护理中的舞会好处，包括通过提供患者的观点来促进临床印象，并通过发现“不言语问题”来促进Agernda。治疗计划，建立患者的关系，并促进患者参与。基于团队的护理可以促进舞会的有效实施。
风湿病学家确定了舞会可以增加临床护理的多种机制，但也注意到实施的几个障碍，质疑舞会的附加值以及有限的干预措施，以改善以患者为中心的结果，以成功地整合以患者为中心的舞会以增强舞会的计划。照顾和满足高质量的基准应优先考虑实体买入和培训，并提供资源以解决结果测量。
To identify rheumatologists’ views on perceived barriers and facilitators to the clinical implementation of patient-reported outcome measures (PROMs) Semi-structured interviews were conducted with academically affiliated clinical rheumatologists. Interviews were audio-recorded and transcribed. De-identified transcripts were independently coded and analyzed for themes. Fifteen attending rheumatologists, 8 women (53%) and 7 men (47%) with a median of 15 years in practice (range 5 to 43) at two urban academic medical centers participated in interviews. Rheumatologists identified several barriers to integrating PROMs in clinical care, highlighting physician buy-in and culture change as significant challenges beyond logistical considerations. They further underscored the lack of effective interventions and resources for addressing the domains of most interest to patients. Physicians also recognized significant benefits of PROMs in clinical care, including contributing to the clinical impression by providing the patient perspective, and promoting agenda setting by uncovering “unspoken questions.” They additionally noted that PROMs could support treatment planning, build patient-physician relationships, and facilitate patient engagement. Participants suggested that technology, physician education, and team-based care could facilitate the effective implementation of PROMs. Rheumatologists identified multiple mechanisms through which PROMs could augment clinical care, but also noted several obstacles to implementation, questioning the added value of PROMs and the limited availability of interventions to improve patient-centered outcomes. Programs seeking to successfully integrate PROMs to enhance patient-centered care and meet quality benchmarks should prioritize physician buy-in and training and provide resources to address the outcomes that are measured.
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影响因子：
3.5
作者：
Lohr, Kathleen N.;Zebrack, Bradley J.
通讯作者：
Zebrack, Bradley J.
影响因子：
3.5
作者：
Santana, Maria J.;Haverman, Lotte;Velikova, Galina
通讯作者：
Velikova, Galina
影响因子：
1.8
作者：
Papuga, M. O.;Dasilva, C.;Baumhauer, J. F.
通讯作者：
Baumhauer, J. F.
影响因子：
2.3
作者：
Callahan, Leigh F.
通讯作者：
Callahan, Leigh F.
DOI：
10.1177/0272989x10386382
发表时间：
2010-11
期刊：
Medical decision making : an international journal of the Society for Medical Decision Making
影响因子：
--
作者：
DuBenske LL;Gustafson DH;Shaw BR;Cleary JF
通讯作者：
Cleary JF