Developing a Standardized Process Assessment for Relationship-Centered Shared Decision-Making (SPARCSdm)

开发以关系为中心的共享决策的标准化流程评估 (SPARCSdm)

• 批准号: 10677664
• 负责人: Trudy Ruth Mallinson
• 金额: $ 46.43万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-05 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10677664
• 关键词: Developing; Standardized; Process; Assessment; Relationship

Project Summary This project's goal is to develop an assessment that captures the process of shared decision-making (SDM) for persons who cannot advocate for themselves because they lack the cognitive capacity to decide for themselves and the ability to communicate their wishes. Current SDM assessments are not designed for these individuals and generally focus on encounter outcomes rather than the process by which SDM unfolds. To address this knowledge gap, a team of multi-disciplinary researchers, healthcare stakeholders, and care partners will collaborate to design and test the observer-rated Standardized Process Assessment of Relationship-Centered Shared Decision-Making (SPARCSdm), informed by our relationship-centered SDM process model. In Aim 1, we will observe, interview and analyze patient- practitioner-care partner triad encounters where decisions are made. These observations will be used to define modifiable collaboration and information exchange skills, identify items and rating scales for the SPARCSdm, and design a prototype assessment including administration procedures. In Aim 2, assessors will be trained using an online, competency-based training developed specifically for this project; once trained, they will observe videotaped SDM encounters and separately score care partners and practitioner on the SPARCSdm. These data, analyzed using the many facets Rasch model (MFRM) to adjust for assessor severity/leniency and encounter complexity, will provide preliminary evidence of SPARCSdm psychometrics, facilitate appraisal of the assessment's conceptual and structural validity, and inform refinements of the online training. In Aim 3, we will apply the Knowledge to Action implementation science strategy to scale up the prototype for future testing by identifying supports and barriers, usability, and acceptability. This project advances care for persons with chronic disabilities and their care partners by developing a process assessment that is relationship-centric, inclusive of multiple perspectives, and user-friendly. As such, it is highly responsive to AHRQ's request for projects that develop an SDM process assessment, informed by a conceptual model, to capture multiple perspectives for priority populations such as persons with disabilities who need chronic care. This assessment is needed because clinical supervisors and medical educators currently struggle to identify when SDM has taken place and which practitioners and care partners need support with SDM skills. Attention to usability and integration of supports and barriers to implementation throughout the design process ensures this project will effectively set the stage for larger scale testing of the SPARCSdm, and longer-term, for measuring the effectiveness of intervention programs aimed at improving SDM.

项目摘要 这个项目的目标是开发一个评估，捕捉过程中的共同决策 (SDM)对于那些因为缺乏认知能力而无法为自己辩护的人， 自己决定，并有能力传达他们的愿望。目前的SDM评估不包括 为这些人设计，通常侧重于遭遇结果，而不是过程， SDM展开的。为了解决这一知识差距，一个由多学科研究人员组成的团队， 利益相关者和护理合作伙伴将合作设计和测试无风险评级的标准化流程 评估以企业为中心的共同决策（SPARCsdm），由我们的 以关系为中心的SDM过程模型。在目标1中，我们将观察、访谈和分析患者- 在做决定的地方，会遇到监护人-护理伙伴三元组。这些观察结果将用于 定义可修改的协作和信息交换技能，确定项目和评级量表， SPARCSdm，并设计一个原型评估，包括管理程序。在目标2中，评估员 将使用专门为此项目开发的基于能力的在线培训进行培训; 经过培训后，他们将观察SDM遭遇的录像，并分别对护理伙伴和医生进行评分 在SPARCSDM上。这些数据，分析使用多方面拉施模型（MFRM），以调整 评估员严重性/宽大性和遭遇复杂性，将提供SPARCSdn的初步证据 心理测量学，促进评估的概念和结构有效性的评估，并告知 完善在线培训。在目标3中，我们将把知识转化为行动 通过确定支持和障碍，可用性， 和可接受性。该项目促进了对慢性残疾人及其护理伙伴的护理 通过开发以关系为中心的过程评估，包括多个视角， 用户友好。因此，它高度响应了亚洲人权问题咨询委员会关于开展可持续发展机制项目的要求。 过程评估，以概念模型为依据，以获取优先级的多个视角 需要长期护理的残疾人等人口。之所以需要这种评估，是因为 临床监督者和医学教育者目前正努力确定SDM何时发生， 哪些从业者和护理伙伴需要SDM技能的支持。关注可用性和集成 在整个设计过程中的支持和实施障碍，确保该项目将 有效地为SPARCSdm的更大规模测试和更长期的测量奠定了基础， 旨在改善SDM的干预方案的有效性。