scholarly journals Vigilance: An Unmeasured Patient-Centered Outcome for Ankle Reconstruction

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0006
Author(s):  
Ellie Pinsker ◽  
Joanna E.M. Sale ◽  
Monique A.M. Gignac ◽  
Timothy R. Daniels ◽  
Dorcas E. Beaton
Keyword(s):  
Treatment Outcomes ◽  
Negative Impact ◽  
Patient Reported Outcome Measures ◽  
Daily Basis ◽  
Patient Reported Outcome ◽  
Mental Load ◽  
Patient Centered ◽  
Qualitative Researcher ◽  
Wide Range ◽  
Patient Reported

Category: Ankle, Ankle Arthritis Introduction/Purpose: A wide range of patient-reported outcome measures are used to evaluate ankle reconstruction outcomes, but there is little agreement regarding which best captures patients’ perceptions of illness and treatment outcomes. There has been little exploration of what outcomes are important to patients. Qualitative work offers one approach to try to understand patients’ experiences of ankle reconstruction for treatment of end-stage ankle osteoarthritis. Methods: Individuals were recruited from an existing cohort of persons who had undergone total ankle replacement or ankle fusion. Twenty-five English-speaking individuals who had surgery at least one year prior and were receptive to in-depth interviews were asked to participate following a routine clinic visit. Semi-structured, face-to-face interviews were conducted by a qualitative researcher in a private hospital room. Results: Twenty-five adults (12 women, 13 men) ages 25–82 years were interviewed for 1–2 hours. Participants commonly described a state of having to keep careful watch for potential environmental challenges on a daily basis. ‘Vigilance’ was related to ongoing symptoms (i.e. pain, stiffness) and concerns related to balance, stability, and damage to the fused ankle or implant. Findings indicated that vigilance existed along a continuum with higher levels associated with stress, mental exhaustion, and a negative impact on relationships with friends and family. Vigilance appeared to effect participants’ perception of their surgical outcome, with high levels of vigilance linked to negative perceptions of outcome. The degree to which individuals perceived they needed to be vigilant was influenced by environmental factors like uneven ground or crowds. Conclusion: Vigilance, or the constant appraisal of the environment and personal ability, is not captured by current instruments assessing ankle reconstruction outcomes. However, the mental load and worry associated with high ‘vigilance’ was important to patients and played a role in their perception of outcome, distinct from related pain or functional status. As such, reducing high levels of vigilance appears to be an appropriate target for patient-centered treatment outcomes and one that can be managed or remedied. A thorough outcome battery for ankle reconstruction should consider this domain.

scholarly journals Patient-Reported Cognitive Outcomes Following Cardiac Surgery: A Descriptive Review

2021 ◽  
Vol 8 ◽  
pp. 237437352198925
Author(s):  
Amanda Robinson ◽  
Edith Pituskin ◽  
Colleen M Norris
Keyword(s):  
Cardiac Surgery ◽  
Cognitive Function ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Cognitive Outcomes ◽  
Patient Centered ◽  
Cognitive Changes ◽  
Practice Nurses ◽  
Patient Reported ◽  
Related Quality

A descriptive review was conducted to evaluate the evidence of cognitive patient-reported outcome measures (PROMs) following cardiac surgery. The search of electronic databases resulted in 400 unique manuscripts. Nine studies met the criteria to be part of the final review. Results of the review suggest that there are few validated PROMs that assess cognitive function in the cardiac surgical population. Furthermore, PROMs have not been used to assess overall cognitive function following cardiac surgery within the past decade. However, one domain of cognitive function—memory—was described, with up to half of patients reporting a decline postoperatively. Perceived changes in cognitive function may impact health-related quality of life and a patient’s overall view of the success of their surgery. Early identification of cognitive changes measured with PROMs may encourage earlier intervention and improve patient-centered care. In clinical practice, nurses may be in the best position to administer PROMs preoperatively and postoperatively.

scholarly journals Patient-Reported Outcomes Measures: An Introduction for Clinicians

2019 ◽  
Vol 4 (1) ◽  
pp. 8-15 ◽  
Author(s):  
Kathryn Yorkston ◽  
Carolyn Baylor
Keyword(s):  
Instrument Development ◽  
Patient Reported Outcomes ◽  
Outcome Measurement ◽  
Communication Disorders ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Centered ◽  
Outcomes Measures ◽  
Patient Reported ◽  
Measurement Tools

Patient-reported outcome measures contain information that comes directly from the patient without interpretation by anyone else. These measures are an important part of a clinicians' arsenal of assessment approaches and are critical in the development of patient-centered approaches to intervention. In this introduction to patient-reported outcome measurement tools, a history is provided of this approach to measurement and its place within the context of clinical research and practice. The process of instrument development and application will be reviewed, along with examples of measurement tools from the field of neurological communication disorders. This introduction is supplemented by references that provide interested readers with more detailed information.

Patient Reported Outcome Measures in Neurologic Communication Disorders: An Update

2015 ◽  
Vol 25 (3) ◽  
pp. 114-120 ◽  
Author(s):  
Michael de Riesthal ◽  
Katherine B. Ross
Keyword(s):  
Clinical Practice ◽  
Outcomes Research ◽  
Outcome Measurement ◽  
Communication Disorders ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Centered ◽  
Rehabilitation Outcomes ◽  
Patient Reported ◽  
Centered Care

In her seminal book on outcome measurement in the field of communication disorders, Carol Frattali (1998) set the path for outcomes research and clinical application in the field of speech-language pathology. In particular, she defined the many possible outcomes that can be measured to examine the influence of an intervention and the ways in which these measures can inform public policy. Of these, patient or client centered measures, which index outcome based on the patient's and family's or caregiver's perspective, have received increasing attention in recent research and clinical practice. These measures examine a variety of patient reported outcomes (PRO) associated with health. PRO measures are being used more commonly in clinical practice and as end points in medical and rehabilitation outcomes research. This perspective reflects the shift in medicine and rehabilitation toward patient-centered care. In this article, we will examine the rationale for using PRO measures, the advantages and challenges for using these tools, and current use of PRO measures in neurological communication disorders.

Assessing Patient-reported Quality of Life Outcomes in Vulva Cancer Patients: A Systematic Literature Review

2018 ◽  
Vol 28 (4) ◽  
pp. 808-817 ◽  
Author(s):  
Ligita Paskeviciute Froeding ◽  
Elfriede Greimel ◽  
Anne Lanceley ◽  
Anne Oberguggenberger ◽  
Claudia Schmalz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Phase 1 ◽  
Reporting Quality ◽  
Bowel Function ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Reported ◽  
Vulva Cancer

ObjectivesVulva cancer (VC) treatment carries a high risk of severe late effects that may have a negative impact on quality of life (QoL). Patient-reported outcome measures (PROMs) are increasingly used when evaluating disease- and treatment-specific effects. However, the adequacy of measures used to assess sequelae and QoL in VC remains unclear. The aims of the present study were to evaluate disease- and treatment-related effects as measured by PROMs in VC patients and to identify available VC-specific PROMs.Methods/MaterialsA systematic literature search from 1990 to 2016 was performed. The inclusion criterion was report of disease- and treatment-related effects in VC patients using PROMs in the assessment. Methodological and reporting quality was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. This systematic review was performed as part of phase 1 of the development of a European Organisation for Research and Treatment of Cancer QoL questionnaire for VC patients.ResultsThe search revealed 2299 relevant hits, with 11 articles extracted including a total of 535 women with VC; no randomized controlled trials were identified. The selected studies exhibited great heterogeneity in terms of PROMs use. Twenty-one different instruments assessed QoL. Most of the questionnaires were generic. Different issues (sexuality, lymphedema, body image, urinary and bowel function, vulva-specific symptoms) were reported as potentially important, but the results were not systematically collected. Only one VC-specific questionnaire was identified but did not allow for assessment and reporting on a scale level.ConclusionsVulva cancer treatment is associated with considerable morbidity deteriorating QoL. To date, there is no validated PROM available that provides adequate coverage of VC-related issues. The study confirms the need for a VC-specific QoL instrument with sensitive scales that allows for broad cross-cultural application for use in clinical trials.

scholarly journals Patient-reported outcome measures in the recovery of adults hospitalised with community-acquired pneumonia: a systematic review

2019 ◽  
Vol 53 (3) ◽  
pp. 1802165 ◽  
Author(s):  
Harry J. Pick ◽  
Charlotte E. Bolton ◽  
Wei Shen Lim ◽  
Tricia M. McKeever
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Community Acquired Pneumonia ◽  
Assessment Tools ◽  
Post Discharge ◽  
Wide Range ◽  
Patient Reported ◽  
Prisma Statement

Symptomatic and functional recovery are important patient-reported outcome measures (PROMs) in community-acquired pneumonia (CAP) that are increasingly used as trial end-points. This systematic review summarises the literature on PROMs in CAP.Comprehensive searches in accordance with the PRISMA statement were conducted to March 2017. Eligible studies included adults discharged from hospital following confirmed CAP and reporting PROMs.15 studies (n=5644 patients) were included; most were of moderate quality. Studies used a wide range of PROMs and assessment tools. At 4–6 weeks post-discharge, the commonest symptom reported was fatigue (45.0–72.6% of patients, three studies), followed by cough (35.3–69.7%) and dyspnoea (34.2–67.1%); corresponding values from studies restricted by age <65 years (two studies) were lower: fatigue 12.1–25.7%, cough 19.9–31.9% and dyspnoea 16.8–27.5%. Functional impairment 4 weeks post-discharge was reported in 18–51% of patients (two studies), while median time to return to normal activities was between 15 and 28 days (three studies).Substantial morbidity is reported by patients up to 6 weeks post-discharge. There is weak methodological consistency across existing studies. A core set of PROMs for use in future studies is suggested.

scholarly journals Patient Reported Outcome Measures (PROMs) for quality of care assessment: a pilot study protocol

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A J Fauci ◽  
A Acampora ◽  
C Cadeddu ◽  
C Angioletti ◽  
A G De Belvis ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Performance Evaluation ◽  
Cancer Patients ◽  
Outcome Measures ◽  
Healthcare Providers ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Centered ◽  
Patient Reported ◽  
Colorectal Cancer Patients

Abstract Background There is emerging interest in integrating Patient Reported Outcome Measures (PROMs) into the assessment of care quality. This study protocol aims at testing the collection and use of PROMs for evaluating and comparing health outcomes by patients with colorectal cancer. This is part of a project of the Istituto Superiore di Sanità and Gruppo Italiano di Reti Oncologiche (GIRO) aimed at promoting Value-Based Healthcare (VBHC) for performance evaluation of oncological healthcare providers. Methods A multicentric prospective observational study will be conducted at the seven GIRO oncological hospitals. For each hospital, 40 colorectal cancer patients undergoing either surgery or surgery plus neoadjuvant therapy, will be recruited (20 colon; 20 rectum) over 12 months. The data will be collected twice (before and after surgery) or three times for patients undergoing neoadjuvant therapy, by using EORTC-C30, a generic module for cancer patients and EORTC-CR29, a specific module for colorectal cancer patients. Collected data will be analyzed descriptively and the scores of each hospital will be compared to the overall scores of all the centers. Additional medical information will be used to adjust for the center casemix. Feedback from health professionals and patients will be collected through structured questionnaires and focus groups. Results The results will be interpreted to assess and compare the health outcomes reported by the patients among the GIRO hospitals. Feedback from health professionals and patients will help identify barriers and facilitators of implementation of PROs collection. Conclusions PROMs have the potential to systematically incorporate the patient perspective into the health outcome measurements for performance evaluation and benchmarking, which is essential to delivering high-value patient-centered care. The PROMs collected in this study will be integrated in a set of process and outcome indicators previously defined within same project. Key messages Patient-Reported Outcome Measures (PROMs) have the potential to systematically incorporate the patient perspective, which is essential to delivering high-value patient-centered care. It is critical to integrate PROMs in performance evaluation and comparison among oncological healthcare providers for improving the quality of care in a Value-Based Healthcare perspective.

Patient experience with patient-reported outcome measures in neurologic practice

Neurology ◽  
2018 ◽  
Vol 91 (12) ◽  
pp. e1135-e1151 ◽  
Author(s):  
Brittany Lapin ◽  
Belinda Udeh ◽  
Jocelyn F. Bautista ◽  
Irene L. Katzan
Keyword(s):  
Outcome Measures ◽  
Patient Experience ◽  
Patient Characteristics ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Successful Implementation ◽  
Patient Centered ◽  
Care Clinic ◽  
Patient Reported ◽  
And Control

ObjectiveTo quantify the neurologic patient experience with patient-reported outcome measures (PROMs) and identify factors associated with a positive PROMs experience.MethodsThis retrospective study included all patients seen in 6 neurologic clinics who completed patient experience questions at least once between October 2015 and September 2016. Questions assessed overall satisfaction with PROMs, as well as 4 facets of the PROM experience: usefulness of questions, ease of understanding, effect on communication with provider, and effect on control of their own care. Clinic and patient characteristics were summarized across questions and predictors of response were identified using multivariable proportional odds models.ResultsA total of 16,157 patients answered generic and condition-specific PROMs, as well as questions on their experience with completing PROMs. The majority of patients agreed/strongly agreed questions were easy to understand (96%), useful (83%), and improved communication (78%) and control (71%). After adjustment for other factors, being younger, black, or depressed, or having lower household income, were independent predictors of high satisfaction with PROMs. Patients who indicated the system improved communication and control of care were more often male, black, and lower income. Variability in responses was shown by clinic.ConclusionGiven the growing importance of patient satisfaction in health care, the patient experience with PROMs is a critical component of their successful implementation and utilization. Findings from this study support the feasibility of collecting PROMs in neurologic practice and the potential as a tool to optimize patient-centered neurologic care.

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