QUALITY-OF-CARE INDICATORS FOR OVERACTIVE BLADDER SYMPTOMS

膀胱过度活动症(OAB)被国际大陆协会定义为尿急，伴有或 无急迫性尿失禁，通常伴有尿频和夜尿。对质量的需求非常大 对有OAB症状的女性的护理研究。这项研究的总体目标是开发和试运行一套 为患有OAB的妇女制定护理质量指标，强调结构、过程和结果措施。 詹妮弗·安格博士，医学博士，公共卫生硕士，最近完成了NRSA健康服务研究奖学金。她 研究提供者变量对女性压力性尿失禁手术结果的影响 大小便失禁。她提出的职业发展计划和相关课程将极大地扩展她 膀胱过度活动区和急迫性尿失禁研究经验。这样做的目的是 获奖期是为了让Anger博士在泌尿健康领域实现完全独立的研究人员 服务研究。她将接受广泛的新培训，每个拟议的具体目标：1) 系统回顾和总结有关OAB治疗的文献，包括结构/过程， 和结果衡量标准。培训：系统的文献回顾2)与患者进行焦点小组 了解接受OAB症状治疗的女性最需要的信息。作为一部分 在这些焦点小组中，我们还将确定什么结果对膀胱过度活动的患者最重要 症状。培训：定性研究方法3)与医生专家进行访谈 大小便失禁。我们将确定他们认为哪些结构、流程和结果措施对 为患有OAB的女性提供优质护理。培训：专家访谈和数据分析4)到 召集一个专家协商一致小组，制定和评定候选指标清单。培训： 兰德/加州大学洛杉矶分校适宜性方法5)试行测试我们最终提出的一套质量指标，以进行评估 它们的可行性和敏感性，同时寻求确定初级保健之间的保健差异 在两个医疗保健系统中的诊所。培训：图表抽象、方法、数据分析 相关性：鉴于膀胱过度活动症的高患病率和低治愈率，提高膀胱过度活动症的质量 通过制定护理质量指标向患有OAB的妇女提供护理将导致更好的 患者的治疗，最终改善了患者的预后。

Overactive bladder (OAB) is defined by the International Continence Society as urinary urgency, with or without urge urinary incontinence, usually with frequency and nocturia. There is a great need for quality-of- care research for women with OAB symptoms. The overall goal of this study is to develop and pilot test a set of indicators of quality of care for women with OAB, emphasizing structure, process, and outcome measures. Dr. Jennifer Anger, MD, MPH, recently completed a NRSA health services research fellowship. She studied the effect of provider variables on outcomes of incontinence surgery for women with stress urinary incontinence. Her proposed career development project and related coursework will greatly expand her research experience into the area of overactive bladder and urge urinary incontinence. The goal of this award period is for Dr. Anger to achieve complete independence as an investigator in urological health services research. She will receive extensive new training with each proposed Specific Aim: 1) To systematically review and summarize the literature on treatment of OAB, incorporating structure/process, and outcomes measures. Training: Systematic literature review 2) To conduct focus groups with patients to understand what information is most needed by women who undergo treatment for OAB symptoms. As part of these focus groups, we will also determine what outcomes matter most to patients with overactive bladder symptoms. Training: Qualitative research methods 3) To conduct interviews with physician experts in incontinence. We will determine what structure, process, and outcomes measures they consider essential to providing excellent quality care for women with OAB. Training: Expert interviews and data analysis 4) To convene an expert consensus panel to develop and rate the list of candidate indicators. Training: The RAND/UCLA Appropriateness Method 5) To pilot test our final set of proposed quality indicators to evaluate their feasibility and sensitivity while simultaneously seeking to identify variation in care between primary care clinics in two healthcare systems. Training: Chart abstraction, methodology, data analysis Relevance: Given the high prevalence and poor cure rate for overactive bladder, improving the quality of care provided to women with OAB through the development of quality-of-care indicators will lead to better patient treatment, and, ultimately, improved patient outcomes.