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Hybschmann J, Sørensen JL, Thestrup J, Pappot H, Boisen KA, Frandsen TL, Gjærde LK. MyHospitalVoice - a digital tool co-created with children and adolescents that captures patient-reported experience measures: a study protocol. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:49. [PMID: 38773648 PMCID: PMC11110337 DOI: 10.1186/s40900-024-00582-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/07/2024] [Indexed: 05/24/2024]
Abstract
BACKGROUND Children and adolescents have the right to participate in decisions concerning their health and express their views, also regarding hospital experiences. Patient-reported experience measures (PREMs) are valuable tools for systematically incorporating patient voices into healthcare systems. New developments have focused on PREMs for children and adolescents, though they are more commonly used in adults. A recent systematic review mapping their use for children and adolescents indicates a growing interest in this area. However, most PREMs are completed by proxy, in this case parents, so they do not necessarily reflect children's experiences or align with their rights. Innovation is required to support and engage children and adolescents in responding to these types of questionnaires. METHODS Collaborating with children and adolescents (4-17 years), the primary aim of this study is to develop and validate the tool MyHospitalVoice containing digital and developmentally appropriate PREMs. The secondary aim is to document and evaluate the approaches used to involve children and adolescents and to assess the impact of their involvement. Based on the European Organisation for Research and Treatment of Cancer framework, we will divide its development and validation into four phases. First, we will discuss PREM items with children and adolescents, who will select and prioritise what they perceive as most important. Second, we will create items targeting different age groups (4-7, 8-12, and 13-17 years) and design a responsive digital interface with child and youth friendly ways of responding to the questionnaires. Third, we will explore how children and adolescents perceive MyHospitalVoice using cognitive interviewing techniques and other age-appropriate methods. Last, we will pilot test MyHospitalVoice to explore patient experiences and response rates. In each phase, children and adolescents will play an active role. We will involve young adults as peer researchers in the project group to ensure that their perspectives are part of the decision-making process. DISCUSSION This project will contribute to research on co-creating with children and adolescents and enhance our understanding of their patient experiences. A validated tool like MyHospitalVoice can help improve quality of care by translating the needs and preferences of children and adolescents into clinical practice.
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Affiliation(s)
- Jane Hybschmann
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen, 2100, Denmark.
| | - Jette Led Sørensen
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen, 2100, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen, 2200, Denmark
| | - Jakob Thestrup
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen, 2100, Denmark
| | - Helle Pappot
- Department of Oncology, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen, 2100, Denmark
| | - Kirsten Arntz Boisen
- Department of Paediatrics and Adolescent Medicine, Center of Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen, 2100, Denmark
| | - Thomas Leth Frandsen
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen, 2100, Denmark
| | - Line Klingen Gjærde
- Mary Elizabeth's Hospital and Juliane Marie Centre, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen, 2100, Denmark
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Pattabi A, Nazarene A, Varghese S, Hassan SM, Nashwan AJ, Patil SK, Singh K. Assessing child satisfaction and expectations for developing a child-friendly environment at the pediatric department in a general hospital in Qatar. Front Pediatr 2024; 12:1279033. [PMID: 38774295 PMCID: PMC11106397 DOI: 10.3389/fped.2024.1279033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 04/01/2024] [Indexed: 05/24/2024] Open
Abstract
Background "Patient-centered" care positions the patient at the core and emphasizes fulfilling their unique needs, preferences, and values. This approach is particularly significant in the context of children. Although widely recognized as necessary, this approach is not universally implemented. The children find themselves in hospital wards where they are required to follow protocols and systems designed primarily for adults. In the appropriate atmosphere, children often express themselves more effectively through words, body language, and play, leading to a richer understanding of their needs. There is growing recognition of the importance of addressing children's concerns regarding hospital environments. Aim This study investigates children's satisfaction with the physical aspect of the hospital environment. Insights from this exploration could provide valuable input for creating hospital environments centered around children's needs and preferences. Methods This mixed-methods study involves children aged 6-14 years with parental consent from a premiere healthcare provider in the state of Qatar. The survey used nine items to gauge satisfaction with the existing hospital environment as a "child-friendly hospital" and another nine items to explore their expectations for such environments. The Mann-Whitney U and Kruskal-Wallis tests as well as thematic analyses were employed to assess the statistical significance of differences in satisfaction levels and children's expectations of the hospital's physical environment. Results A total of 398 children participated in the study. Of them, 40.3% were aged 6-8 years; 60.3% had experienced two to five hospital visits; 55.8% of children participated during their outpatient service visit; and 31.7% were Asian. Children's satisfaction levels with various aspects of the hospital environment-including its physical appearance, signage, lounge, consultant rooms, corridors, bedrooms, TV content, toys, and staff uniforms-were in the range of 42.9%-59%. The children expressed a desire for a hospital environment that is spacious, colorful, attractive, and filled with cartoon characters and toys in the children's hospital from the front lounge to the inpatient units. Conclusion The findings underline the importance of considering the perspectives of children in evidence-based healthcare design. The study reveals that children's satisfaction with the hospital environment is generally average or below average. Ultimately, a "child-friendly hospital environment" integrates children's rights into healthcare to significantly improve outcomes.
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Affiliation(s)
- Amudha Pattabi
- Nursing and Midwifery Education Department, Hamad Medical Corporation, Doha, Qatar
| | - Ananth Nazarene
- Mental Health Services, Hamad Medical Corporation, Doha, Qatar
| | - Sejo Varghese
- Mental Health Services, Hamad Medical Corporation, Doha, Qatar
| | | | - Abdulqadir J. Nashwan
- Department of Nursing Education and Practice Development, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Surekha Kiran Patil
- Nursing and Midwifery Education Department, Hamad Medical Corporation, Doha, Qatar
| | - Kalpana Singh
- Nursing and Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar
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Nafees Z, Ferreira J, Guadagno E, Wray J, Anderzén-Carlsson A, Poenaru D. Adaptation, Translation, and Validation of a Patient-Reported Experience Measure for Children and Young People for the Canadian Context. J Pediatr Surg 2024; 59:810-817. [PMID: 38369398 DOI: 10.1016/j.jpedsurg.2024.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/22/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Patient-reported experience measures (PREMs) evaluate children's and young people's (CYP) perceptions of care. An important PREM developed with and for children was created in London, UK. Given the absence of similar North American instruments, we aimed to adapt, translate, and linguistically validate this instrument for use in a Canadian pediatric outpatient setting. METHODS A qualitative design was used, involving CYP and their parents/caregivers. Phase 1 entailed the English survey adaptation using think-aloud testing, revision, and cognitive testing. Phase 2 involved translation into French, revision and back-translation, and cognitive testing. Phase 3 encompassed a cross-validation of the English and French versions of the adapted instrument. RESULTS Fifty-five children in 3 age groups (8-11y, 12-13y, 14-16y) participated in creating the Canadian PREM. In Phases 1 and 2, 41 children participated in reviewing and updating specific questions in the instrument, resulting in adjustments and revisions based on their feedback. In Phase 3, 14 bilingual children linguistically validated the PREM instrument. CONCLUSIONS This study reports the development of the first Canadian PREM specifically tailored to children. By incorporating the perspectives and preferences of CYP in clinical practice, this approach has the potential to amplify the delivery of patient-centered care for this vulnerable population and ensure that the needs and voices of CYP are acknowledged. LEVEL OF EVIDENCE V, Therapeutic.
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Affiliation(s)
- Zanib Nafees
- Department of Surgical and Interventional Sciences, McGill University Faculty of Medicine and Health Sciences, Montreal, Quebec, Canada.
| | - Julia Ferreira
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Elena Guadagno
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jo Wray
- Great Ormond Street Hospital for Children (GOSH), London, United Kingdom
| | - Agneta Anderzén-Carlsson
- University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Dan Poenaru
- Department of Surgical and Interventional Sciences, McGill University Faculty of Medicine and Health Sciences, Montreal, Quebec, Canada; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
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Rudilla D, Alonso T, García E, Pérez P, Valenzuela C, Girón R, Zamora E, Soriano J, Landete P, Ancochea J. Psychometric Validation of the Patient-Reported Experience Measure (PREM) Questionnaire "HowRwe" in Patients With Respiratory Disease Receiving Home Respiratory Therapies. OPEN RESPIRATORY ARCHIVES 2024; 6:100304. [PMID: 38496265 PMCID: PMC10943053 DOI: 10.1016/j.opresp.2024.100304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 01/28/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction The patient experience is defined as all the interactions that occur between patients and the healthcare system. The experience of patients with respiratory disease with home respiratory treatments (HRT) is not captured in currently available Patient-Reported Outcome Measures (PROM). We present the psychometric validation of the Patient-Reported Experience Measure (PREM) 'HowRwe' in Spanish and for respiratory patients with HRT. Methods After translation following ISPOR guidelines (International Society for Pharmacoeconomics and Outcomes Research), the questionnaire was administered to adult respiratory patients who were receiving treatment at Hospital Universitario de La Princesa. The administration was done in two stages with 6 months of difference between the pre- and post-test. Results We studied 228 respiratory patients, with a mean (SD) age of 64.1 (13.2) years, 52.2% were men, 68.0% were married or coupled, and 56.6% were retired. Reliability coefficients of the scale were adequate, with α = .921 and Ω = .929 for pre-test, and α = .940 and Ω = .958 for post. The confirmatory factor analysis tested for pre- and post-intervention, showed an excellent overall fit: χ2(2) = 49.380 (p < .001), CFI = .941 and SRMR = .072; and χ2(2) = 37.579 (p < .001), CFI = .982 and SRMR = .046, respectively. No statistically significant associations were observed for neither age, adherence nor quality of life, except between HowRwe post-test and quality of life pre-test (r = .14 [.01,.26]; p = .035). No significant differences were found in sociodemographic variables. No differences in pre-test or post-test were found in effect of HRT. 85.6% of patients found the content of HowRwe "Useful", and the preferred channel to respond it were paper, app and email. Conclusions The Spanish version of the 'HowRwe' questionnaire to measure the experience in respiratory patients with home respiratory treatments (HRT), has adequate psychometric properties and conceptual and semantic equivalence with the original English version.
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Affiliation(s)
- David Rudilla
- Air Liquide Healthcare, Spain
- Hospital Universitario de La Princesa, Spain
| | | | | | | | | | - Rosa Girón
- Hospital Universitario de La Princesa, Spain
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Naeem B, Nasim J, Anwar A, Noor S, Arshad A, Zamrood Khan M, Ahmed M, Shah IA. Assessment of parental satisfaction with paediatric health services in public sector tertiary hospitals within a low-income setting using Patient Satisfaction Questionnaire (PSQ-18). BMJ Paediatr Open 2024; 8:e002418. [PMID: 38423744 DOI: 10.1136/bmjpo-2023-002418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 02/14/2024] [Indexed: 03/02/2024] Open
Abstract
INTRODUCTION Patient satisfaction is an integral part of healthcare quality, impacting treatment adherence, patient loyalty and healthcare utilisation. Parental satisfaction is particularly crucial as parents influence decision-making for their child's healthcare. OBJECTIVE The objective was to assess parental satisfaction levels (as measured by Patient Satisfaction Questionnaire-18 (PSQ-18)) related to paediatric healthcare services and identify specific factors significantly influencing parental satisfaction with paediatric healthcare services. METHODOLOGY This is a descriptive cross-sectional study that used a structured questionnaire based on the PSQ-18. The study was conducted in Faisalabad, Islamabad, Peshawar and Swat. Seven subscales measured satisfaction across various dimensions. RESULTS We found 882 suitable responses indicating a diverse participant demographic, with the largest group in the 6-12 years age category. The overall mean parental satisfaction score was 2.0±0.5 (40.0%). Notably, financial aspects scored highest at 2.8 (55%), followed by accessibility and convenience at 2.0 (40.5%). However, lower satisfaction scores in the interpersonal relationship (1.8±0.5) and technical quality (1.8±0.5) domains were recorded. Sociodemographic analysis indicated age, education and occupation significantly influenced satisfaction. Conversely, factors such as gender, residence and the presence of chronic disease did not significantly impact satisfaction levels. CONCLUSION The study offers valuable insights into paediatric patient satisfaction in Pakistan, emphasising the need for targeted interventions and improvements in specific domains to enhance overall healthcare quality.
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Affiliation(s)
| | | | - Amna Anwar
- Federal Medical College (FMC), Islamabad, Pakistan
| | - Sheh Noor
- Hayatabad Medical Complex, Peshawar, Pakistan
| | - Aqdas Arshad
- Mohi-ud-Din Islamic Medical College, Mirpur, Pakistan
| | | | | | - Imad Ali Shah
- National University of Science and Technology (NUST), Islamabad, Pakistan
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Ionov M, Dubinina E, Tregubenko I, Zvartau N, Konradi A. Russian-language translation and cultural adaptation of the Norwegian 'Patient Experience Questionnaire'. PEC INNOVATION 2023; 2:100174. [PMID: 37384153 PMCID: PMC10294072 DOI: 10.1016/j.pecinn.2023.100174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/30/2023]
Abstract
The availability of patient-reported experience measures (PREM) is an unmet need in Russian healthcare. Objective To translate, adapt culturally, and validate PREM for outpatients. Methods A core set of questions from the Patient Experience Questionnaire (PEQ, in Norwegian, available in English) was translated to Russian (forward-backward translation). Acceptability, construct validity, and reliability were assessed. Patients aged ≥18 y.o. were invited to complete the questionnaire via QR-code within 24 h after a medical encounter. Results A questionnaire with adequate conceptual and linguistic equivalence was obtained. For four questions, a rating scale was replaced by Likert-type. A total of 308 responses were received (median age 55 y.o., 52% females). The correlation matrix was factorable. Four factors were extracted using varimax rotation: 1) outcome of this specific visit; 2) communication experiences; 3) communication competency; 4) emotions after this visit. These explained 65.4% of the total variance. Three items were excluded. The model was confirmed to be adequate. The Cronbach alpha was >0.9. Item-total correlation confirmed discriminative validity. Conclusion These preliminary results show that the Russian version of PEQ, adapted to national features, shows good psychometric properties. External validation is needed for the broad implementation of this PREM. Innovation This research is first attempt to use PREM in the Russian Federation. The use of quick response codes is feasible and eases survey conduction. The more PREMs are used the higher the quality of healthcare.
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Affiliation(s)
- Mikhail Ionov
- Research Laboratory on Pathogenesis and Therapy of Arterial Hypertension, Almazov National Medical Research Center of Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation
| | - Elena Dubinina
- Department of Clinical Psychology and Psychological Assistance, Russian State Pedagogical University of Russia, Saint-Petersburg, Russian Federation
- Laboratory of Clinical Psychology and Psychodiagnostics, Bekhterev National Research Medical Center for Psychiatry and Neurology of Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation
| | - Ilya Tregubenko
- Department of Psychology of Professional Activity and Information Technologies in Education, Russian State Pedagogical University of Russia, Saint-Petersburg, Russian Federation
- Department of General and Clinical Psychology, Pavlov First St.Petersburg State Medical University, Saint-Petersburg, Russian Federation
| | - Nadezhda Zvartau
- Research Laboratory on Pathogenesis and Therapy of Arterial Hypertension, Almazov National Medical Research Center of Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation
| | - Alexandra Konradi
- Research Laboratory on Pathogenesis and Therapy of Arterial Hypertension, Almazov National Medical Research Center of Ministry of Health of the Russian Federation, Saint-Petersburg, Russian Federation
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Kramer JM, Beasley JB, Caoili A, Kalb L, Urquilla MP, Klein AE, Poncelet J, Black S, Tessler RC. Development and content validity of the Person Experiences Interview Survey (PEIS): a measure of the mental health services experiences of people with developmental disabilities. Front Psychiatry 2023; 14:1271210. [PMID: 38098638 PMCID: PMC10719843 DOI: 10.3389/fpsyt.2023.1271210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/07/2023] [Indexed: 12/17/2023] Open
Abstract
Purpose People with developmental disabilities and mental health service experiences have a right to be included in healthcare decisions, including the evaluation of their mental health services and providers. However, few self-report measures address this need. This study aimed to fill this gap by developing and evaluating the content validity, including comprehension, relevance, and comprehensiveness, of the Person Experiences Interview Survey (PEIS) with people with developmental disabilities and mental health experiences. Methods The research team established a measurement framework based on the Family Experiences Interview Survey (FEIS), resulting in 21 PEIS items that were written in collaboration with young adults with developmental disabilities and mental health service experiences. Comprehension, relevance, and comprehensiveness were evaluated through cognitive interviews with people with developmental disabilities and mental health service experiences (respondents; n = 9) ages 23-49 years. Comprehensiveness and relevance were also evaluated in focus groups with family caregivers (n = 9) and mental health providers (n = 10) who serve this population. Two researchers independently coded open-ended responses to the PEIS for comprehension. A content validity index (CVI), indicating relevance, was calculated for each participant group for each item, and comprehensiveness was rated for item sets. Results Fifteen of the 21 items met the criteria of ≥80% comprehension, with 89-100% of responses containing all or some intended information. All items met the CVI ≥80% criterion in at least two of the three groups. In all item sets, between 1 and 4 family members or providers felt one question was missing. Respondents used the response scale in a manner that corresponded with their open-ended descriptions, and family caregivers and providers had positive feedback about the response scale's visual cues and number of choices. Using these findings, four items were removed and six items were revised, resulting in a 17-item measure. Conclusion This study presents a novel and promising measure, the Person Experiences Interview Survey (PEIS). It also demonstrates that the employment of accessible methods allows people with developmental disabilities to meaningfully evaluate mental health services and providers. The PEIS shows great promise for application in the field by engaging those directly involved in the evaluation of mental health services and providers.
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Affiliation(s)
- Jessica M. Kramer
- Department of Occupational Therapy, University of Florida, Gainesville, FL, United States
| | - Joan B. Beasley
- Institute on Disability, University of New Hampshire, Durham, NH, United States
| | - Andrea Caoili
- National Center for START Services, Institute on Disability, University of New Hampshire, Durham, NH, United States
| | - Luke Kalb
- Kennedy Krieger Institute, Baltimore, MD, United States
| | - Micah Peace Urquilla
- National Center for START Services, Institute on Disability, University of New Hampshire, Durham, NH, United States
| | - Ann E. Klein
- National Center for START Services, Institute on Disability, University of New Hampshire, Durham, NH, United States
| | - Janie Poncelet
- National Center for START Services, Institute on Disability, University of New Hampshire, Durham, NH, United States
| | - Sandra Black
- National Center for START Services, Institute on Disability, University of New Hampshire, Durham, NH, United States
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Pei C, Han X, Liu Q, Hu G. Case-mix adjustment of patient-reported experience measures in National Regional Center for Pediatric. Pediatr Res 2023; 94:1562-1569. [PMID: 36690747 DOI: 10.1038/s41390-023-02488-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/25/2022] [Accepted: 01/04/2023] [Indexed: 01/24/2023]
Abstract
BACKGROUND The aim of the study was to identify case-mix adjusters for the Chinese version of the Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child-HCAHPS) and assess the impact of case-mix adjustment on patient experience measures in China. METHODS This study analyzed data collected from six National Regional Center for Pediatric across China retrospectively. Participants were children aged ≤17 years and their guardians who completed the survey. The Chinese Child-HCAHPS was used to measure pediatric inpatient care experience. Candidate case-mix adjusters were assessed using a summary measure of explanatory power. Changes in scores and rankings of the six centers were quantified to assess the impact of adjustment. RESULTS A total of 2708 respondents completed the survey from January to March 2021, with a response rate of 7-15%. The child's global health status and the respondent being the child's mother were identified as case-mix adjusters, and case-mix adjustment models for 18 patient experience items were constructed. Kendall's τ correlation of hospital rankings before and after adjustment ranged from 0.73 to 1.00. CONCLUSIONS Although the impact of case-mix adjustment may appear modest in our sample, it demonstrated the feasibility, necessity, and methodology for further development of case-mix adjustment models in pediatric healthcare facilities in China. IMPACT Case-mix adjustment models adjust for factors that are unamendable by healthcare providers that may affect patient experience ratings, thereby improving the comparability of institutional-level ratings. Standardized case-mix adjustment protocols for quality measures need to be modified in different settings. This is the first study to identify adjustment variables and the possible impact of case-mix adjustment on pediatric inpatients' experience measures in a Chinese population. This study provided evidence on the feasibility and necessity for further development of case-mix adjustment models for pediatric healthcare facilities in China.
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Affiliation(s)
- Chenyang Pei
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xueyan Han
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Medical Statistics, Peking University First Hospital, Beijing, China
| | - Qiannan Liu
- National Institute of Hospital Administration, NHC, Beijing, China
| | - Guangyu Hu
- Institute of Medical Information/Center for Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Ažukaitis K, Puronaitė R, Vaitkevičienė GE, Trinkūnas J, Jankauskienė A, Jankauskienė D. Integrated Collection of Patient-Reported Outcomes and Experiences in Children with Kidney and Hematological Diseases: A Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1245. [PMID: 37508742 PMCID: PMC10377830 DOI: 10.3390/children10071245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023]
Abstract
We aimed to explore the feasibility and potential relevance of integrated electronic collection of patient-reported outcome and experience measures (PROM and PREM) in children with special healthcare needs (CSHCN) by using the example of children with kidney and hematological diseases. We performed a cross-sectional, single-center study of children <18 years of age. Children (≥10 years) and their parents received Generic PedsQL Core Scale 4.0 and custom PREM surveys to their email addresses via the REDCap platform, and the results were integrated into the hospital's electronic health records system. A total of 192 patients (98 with kidney diseases and 94 with hematological diseases) were enrolled. The overall response rate was 51%, and the median time for completion of each proxy questionnaire was approximately three minutes. The lowest PROM scores were observed in the emotional and school functioning dimensions. More favorable experiences in the diagnosis establishment process were associated with higher scores in physical, social, school functioning, and total PROM scores. A better evaluation of the hospital's environment was associated with higher social functioning, while better information provision correlated with higher physical functioning and total PROM scores. Our data indicates that integrated electronic collection of PROMs and PREMs in the population of CSHCN is feasible, but efforts to increase the response rate are needed. The associations between PROMs and PREMs suggest that future studies exploring targeted interventions at the healthcare service level to improve subjective patient outcomes are needed.
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Affiliation(s)
- Karolis Ažukaitis
- Clinic of Pediatrics, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
| | - Roma Puronaitė
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
| | - Goda Elizabeta Vaitkevičienė
- Clinic of Pediatrics, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
| | - Justas Trinkūnas
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
- Faculty of Fundamental Sciences, Vilnius Gediminas Technical University, 10223 Vilnius, Lithuania
| | - Augustina Jankauskienė
- Clinic of Pediatrics, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
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Bele S, Rabi S, Zhang M, Ahmed S, Paolucci EO, Johnson DW, Quan H, Santana MJ. Uptake of pediatric patient-reported outcome and experience measures and challenges associated with their implementation in Alberta: a mixed-methods study. BMC Pediatr 2023; 23:369. [PMID: 37464329 PMCID: PMC10353095 DOI: 10.1186/s12887-023-04169-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 06/29/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Implementing Patient-reported Outcome Measures (PROMs) and Patient-reported Experience Measures (PREMs) is an effective way to deliver patient- and family-centered care (PFCC). Although Alberta Health Services (AHS) is Canada's largest and fully integrated health system, PROMs and PREMs are yet to be routinely integrated into the pediatric healthcare system. This study addresses this gap by investigating the current uptake, barriers, and enablers for integrating PROMs and PREMs in Alberta's pediatric healthcare system. METHODS Pediatric clinicians and academic researchers with experience using PROMs and PREMs were invited to complete a quantitative survey. Additionally, key stakeholders were qualitatively interviewed to understand current challenges in implementing pediatric PROMs and PREMs within AHS. Quantitative data gathered from 22 participants were descriptively analyzed, and qualitative data from 14 participants were thematically analyzed. RESULTS Participants identified 33 PROMs and 6 PREMs showing diversity in the types of pediatric PROMs and PREMs currently being used in Alberta and their mode of administration. The qualitatively identified challenges were associated with patients, family caregivers, and clinicians. The absence of system-level support, such as integration within electronic medical records, is considered a significant system-level challenge. CONCLUSIONS The significant variation in the types of PROMs and PREMs used, the rationale for their use, and their mode of administration demonstrate the diverse and sporadic use of these measures in Alberta. These findings highlight the need for province-wide uniform implementation of pediatric PROMs and PREMs in Alberta. Our results could benefit healthcare organizations in developing evidence-based PROM and PREM implementation strategies in pediatrics.
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Affiliation(s)
- Sumedh Bele
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada.
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.
- Patient Engagement Team, Alberta SPOR Support Unit, Calgary, Canada.
| | - Sarah Rabi
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Muning Zhang
- Cumming School of Medicine, Bachelor of Health Sciences Program, University of Calgary, Calgary, Canada
| | - Sadia Ahmed
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
- Patient Engagement Team, Alberta SPOR Support Unit, Calgary, Canada
| | - Elizabeth Oddone Paolucci
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - David W Johnson
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
- Newborn, Child and Youth Strategic Clinical Network, Alberta Health Services Maternal, AB, Calgary, Canada
- Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Knowledge Translation Team, Alberta SPOR Support Unit, Calgary, Canada
| | - Hude Quan
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Data and Services Team, Alberta SPOR Support Unit, Calgary, Canada
| | - Maria J Santana
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Patient Engagement Team, Alberta SPOR Support Unit, Calgary, Canada
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11
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Mukherjee S, Richardson N, Beresford B. Hospital healthcare experiences of children and young people with life-threatening or life-shortening conditions, and their parents: scoping reviews and resultant conceptual frameworks. BMC Pediatr 2023; 23:366. [PMID: 37460965 PMCID: PMC10351142 DOI: 10.1186/s12887-023-04151-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 06/24/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Patient experience is a core component of healthcare quality. Patient-reported experience measures (PREMs) are increasingly used to assess this, but there are few paediatric PREMs. This paper reports the first stage of developing two such measures, one for children and young people (0-18 years) (CYP) with a life-threatening or life-shortening condition (LT/LSC), and one for their parents. It comprised parallel scoping reviews of qualitative evidence on the elements of health service delivery and care that matter to, or impact on, CYP (Review 1) and parents (Review 2). METHODS Medline and PsychINFO (1/1/2010 - 11/8/2020) and CINAHL Complete (1/1/2010 - 4/7/2020) were searched and records identified screened against inclusion criteria. A thematic approach was used to manage and analyse relevant data, informed by existing understandings of patient/family experiences as comprising aspects of staff's attributes, their actions and behaviours, and organisational features. The objective was to identity the data discrete elements of health service delivery and care which matter to, or impact on, CYP or parents which, when organised under higher order conceptual domains, created separate conceptual frameworks. RESULTS 18,531 records were identified. Sparsity of data on community-based services meant the reviews focused only on hospital-based (inpatient and outpatient) experiences. 53 studies were included in Review 1 and 64 in Review 2. For Review 1 (CYP), 36 discrete elements of healthcare experience were identified and organized under 8 higher order domains (e.g. staff's empathetic qualities; information-sharing/decision making; resources for socializing/play). In Review 2 (parents), 55 elements were identified and organized under 9 higher order domains. Some domains were similar to those identified in Review 1 (e.g. professionalism; information-sharing/decision-making), others were unique (e.g. supporting parenting; access to additional support). CONCLUSIONS Multiple and wide-ranging aspects of the way hospital healthcare is organized and delivered matters to and impacts on CYP with LT/LSCs, and their parents. The aspects that matter differ between CYP and parents, highlighting the importance of measuring and understanding CYP and parent experience seperately. These findings are key to the development of patient/parent experience measures for this patient population and the resultant conceptual frameworks have potential application in service development.
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Affiliation(s)
- Suzanne Mukherjee
- Social Policy Research Unit, School of Business and Society, University of York, York, YO10 5ZF, UK.
| | - Natalie Richardson
- Social Policy Research Unit, School of Business and Society, University of York, York, YO10 5ZF, UK
| | - Bryony Beresford
- Social Policy Research Unit, School of Business and Society, University of York, York, YO10 5ZF, UK
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12
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Yeung M, Hagel BE, Bobrovitz N, Stelfox TH, Elliot A, MacPherson A, McBeth P, Schuurmann N, Yanchar NL. Between paradigms: Comparing experiences for adolescents treated at pediatric and adult trauma centres. Injury 2023:S0020-1383(23)00363-7. [PMID: 37147145 DOI: 10.1016/j.injury.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/31/2023] [Accepted: 04/12/2023] [Indexed: 05/07/2023]
Abstract
INTRODUCTION Injured adolescents may be treated at pediatric trauma centres (PTCs) or adult trauma centres (ATCs). Patient and parent experiences are an integral component of high-quality health care and can influence patient clinical trajectory. Despite this knowledge, there is little research on differences between PTCs and ATCs with respect to patient and caregiver-reported experience. We sought to identify differences in patient and parent-reported experiences between the regional PTC and ATC using a recently developed Patient and Parent-Reported Experience Measure. METHODS We prospectively enrolled patients (caregivers) aged 15-17 (inclusive), admitted to the local PTC and ATC for injury management (01/01/2020 - 31/05/2021) We provided a survey 8-weeks post-discharge to query acute care and follow-up experience. Patient and parent experiences were compared between the PTC and ATC using descriptive statistics, chi-square tests for categorical and independent t-tests for continuous variables. RESULTS We identified 90 patients for inclusion (51 PTC, and 39 ATC). From this population, we had 77 surveys (32 patient and 35 caregiver) completed at the PTC, and 41 (20 patient and 21 caregiver) at the ATC. ATC patients tended to be more severely injured. We identified few differences in reported experience on the patient measure but identified lower ratings from caregivers of adolescents treated in ATCs for the domains of information and communication, follow-up care, and overall hospital scores. Patients and parents reported poorer family accommodation at the ATC. CONCLUSION Patient experiences were similar between centres. However, caregivers report poorer experiences at the ATC in several domains. These differences are multifaceted, and may reflect differing patient volumes, effects of COVID-19, and healthcare paradigms. However, further work should target information and communication improvement in adult paradigms given its impact on other domains of care.
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Affiliation(s)
- Matthew Yeung
- Cumming School of Medicine, University of Calgary; Health Sciences Centre, Foothills campus, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada
| | - Brent E Hagel
- Alberta Children's Hospital Research Institute, University of Calgary, Room 293, Heritage Medical Research Building, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada
| | - Niklas Bobrovitz
- Temerty Faculty of Medicine, University of Toronto, Temerty Faculty of Medicine, 1 King's College Circle Medical Sciences Building, Room 2109, Toronto, ON M5S 1A8, Canada
| | - Thomas H Stelfox
- Department of Critical Care, University of Calgary, Foothills Medical Centre, 1403 29St NW, Calgary, AB T2N 2T9, Canada
| | - April Elliot
- Department of Pediatrics, Alberta Children's Hospital, 29 Oki Drive, Calgary, AB T2B 6A8, Canada
| | - Alison MacPherson
- Faculty of Health, York University, 337 Norman Bethune College, 170 Campus Walk, North York, ON M3J 1P3, Canada
| | - Paul McBeth
- Department of Surgery, University of Calgary, North Tower, Foothills Medical Centre, 1403 29St NW, Calgary, AB T2N 2T9, Canada
| | - Nadine Schuurmann
- Department of Geography, RCB 6119/7134, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Natalie L Yanchar
- Natalie L Yanchar: Department of Surgery, University of Calgary, Alberta Children's Hospital, 28 Oki Drive NW, Calgary, AB T3B 6A8, Canada.
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13
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Inhestern L, Brandt M, Driemeyer J, Denecke J, Johannsen J, Bergelt C. Experiences of Health Care and Psychosocial Needs in Parents of Children with Spinal Muscular Atrophy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5360. [PMID: 37047974 PMCID: PMC10094281 DOI: 10.3390/ijerph20075360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 06/19/2023]
Abstract
Spinal muscular atrophy (SMA) is a neurodegenerative disorder that is characterized by progressive weakness, respiratory insufficiency, and dysphagia. Due to symptom burden and disease progress, its care management and impact on daily life can severely burden the families of affected children. The objectives of this study are (1) to explore the health care experiences and (2) to investigate the psychosocial needs of the parents of children with SMA. In total, 29 parents of patients with SMA participated in our study. All children received supportive therapy (e.g., physiotherapy) and most were dependent on medical equipment. Parents perceived the health care positively regarding team quality, communication and access to medical care. An assessment of the impact of the child's health on the family (e.g., stressors, burden, consequences) is not routinely integrated into care. On average, parents reported low to medium levels of psychosocial needs. Due to the complex health care needs of SMA patients, the health care experiences of parents can provide relevant information on care delivery. To enhance the inclusion of psychosocial and emotional issues, as well as family impact, into routine health care, health care providers should be sensitive towards parental needs for consistency in the health care team and emotional aspects and, if applicable, address them proactively.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Maja Brandt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Joenna Driemeyer
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Jonas Denecke
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Jessika Johannsen
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
- Department of Medical Psychology, University Medicine Greifswald, 17475 Greifswald, Germany
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14
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McCabe E, Rabi S, Bele S, Zwicker JD, Santana MJ. Factors affecting implementation of patient-reported outcome and experience measures in a pediatric health system. J Patient Rep Outcomes 2023; 7:24. [PMID: 36892738 PMCID: PMC9998780 DOI: 10.1186/s41687-023-00563-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/21/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND The use of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in pediatric clinical practice can enhance clinical care and bring children and families' perspectives into evaluations of healthcare services. Implementing these measures is complex and requires a thorough assessment of the context of implementation The purpose of this study is to describe the barriers and facilitators to PROMs and PREMs implementation and to recommend strategies for implementing these measures in a pediatric health system. METHODS We used a qualitative descriptive approach to analyse data from interviews to understand the experiences of PROMs and PREMs users across different pediatric settings in a single Canadian healthcare system. RESULTS There were 23 participants representing a variety of roles within the healthcare system and pediatric populations. We found five main factors that affected implementation of PROMs and PREMs in pediatric settings: 1) Characteristics of PROMs and PREMs; 2) Individual's beliefs; 3) Administering PROMs and PREMs; 4) Designing clinical workflows; and 5) Incentives for using PROMs and PREMs. Thirteen recommendations for integrating PROMs and PREMs in pediatric health settings are provided. CONCLUSIONS Implementing and sustaining the use of PROMs and PREMs in pediatric health settings presents several challenges. The information presented will be useful for individuals who are planning or evaluating the implementation of PROMs and PREMs in pediatric settings.
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Affiliation(s)
- Erin McCabe
- School of Public Policy, University of Calgary, Calgary, Canada. .,Department of Pediatrics, University of Calgary, Calgary, Canada.
| | - Sarah Rabi
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Sumedh Bele
- Patient Engagement Team, Alberta Strategy for Patient-Oriented Research Support Unit, Calgary, Canada
| | - Jennifer D Zwicker
- School of Public Policy, University of Calgary, Calgary, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Maria J Santana
- Department of Pediatrics, University of Calgary, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Canada.,Patient Engagement Team, Alberta Strategy for Patient-Oriented Research Support Unit, Calgary, Canada
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15
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Zhuang Y, Zhang R, Gao XR, Zhu LH, Latour JM. Validation of the Chinese Empowerment of Parents in the Intensive Care (EMPATHIC-30) Questionnaire Among Parents in Neonatal Intensive Care Units: A Prospective Cross-Sectional Study. Front Pediatr 2022; 10:851291. [PMID: 35433534 PMCID: PMC9005953 DOI: 10.3389/fped.2022.851291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There are no specific validated questionnaires assessing satisfaction of family-centered care experienced by parents of infants hospitalized in Chinese Neonatal Intensive Care Units (NICU). AIM To adapt and test the reliability and validity of the Chinese version of the EMPATHIC-30 questionnaire in NICU settings. METHODS A prospective, cross-sectional design was adopted. The EMPATHIC-30 questionnaires were completed by parents of infants admitted to one of the four NICUs at Hunan Children's Hospital, China, between November 2018 and 2019. Inclusion criteria were parents whose infants were admitted to the NICU for at least 5 days. Exclusion criteria were parents whose children were discharged within 5 days after admission or whose infants died in the NICU. Reliability was tested with Cronbach's alpha. The congruent validity was tested using Spearman's Rank correlation analysis, and the non-differential validity was tested using Cohen's d. RESULTS Parents of 619 infants discharged from the NICUs completed and returned the questionnaire. Most infants were male (n = 337, 54.4%) and infants' length of stay was a median of 21 days (IQR = 14-37). Mostly, mothers completed the questionnaire (n = 523, 84.5%). The Cronbach's alpha values of the five individual domains were between 0.67 and 0.95, and the alpha of the total questionnaire was.90, providing an adequate internal consistency. Congruent validity was measured by correlating the five domains with four standard satisfaction scales, documenting a weak correlation (r s -0.025-0.327). Non-differential validity showed some significant effect size between four binary variables (mechanical ventilation, unplanned admission, admission after surgery, length of stay) four of the five domains. CONCLUSION The Chinese version of EMPATHIC-30 questionnaire showed acceptable psychometric properties. This instrument might be considered a suitable instrument to measure parent satisfaction among Chinese parents whose infants are admitted to an NICU. Measuring parent satisfaction with this instrument might contribute to improving family-centered care initiatives in NICUs with Chinese parents.
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Affiliation(s)
- Yan Zhuang
- Neonatal Department, Hunan Children's Hospital, Changsha, China
| | - Rong Zhang
- Neonatal Department, Hunan Children's Hospital, Changsha, China
| | - Xi-Rong Gao
- Neonatal Department, Hunan Children's Hospital, Changsha, China
| | - Li-Hui Zhu
- Nursing Department, Hunan Children's Hospital, Changsha, China
| | - Jos M Latour
- Nursing Department, Hunan Children's Hospital, Changsha, China.,Faculty of Health, University of Plymouth, Plymouth, United Kingdom
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