Exploring young patients’ perspectives on rehabilitation care: methods and challenges of organizing focus groups for children and adolescents

BACKGROUND

In research on quality of care, the experiences of children and (pre)adolescents are usually assessed by asking their parents. However, these young patients may have preferences of their own, and their experiences do not necessarily concur with those of their parents. Therefore, our research aimed to give young patients an opportunity to speak up for themselves.

METHODS

Focus group meetings and online focus groups were organized for two age groups (8–11 and 12–15 years) of young patients from two Dutch rehabilitation centres, with the use of a tailored interview technique. The feasibility and applicability of both types of focus groups were assessed.

RESULTS

For both types of focus groups, recruitment proved a major problem. The focus group meetings with (pre)adolescents proved both feasible and applicable in obtaining information regarding the preferences and experiences towards rehabilitation care. Regarding children's meetings, there were mixed results. The setting suited most of them, but some were more anxious. In general, online focus groups were less successful than expected for both age groups.

CONCLUSIONS

Possibilities for enhancing the recruitment rate should be considered, as the low participation rates limited generalizability of focus group results. The tailored design proved useful for obtaining relevant input from (pre)adolescents through meetings, but, especially for children, repeated meetings or other locations (e.g. at home) could be considered. This may make participants more at ease. For both age groups, the online focus groups proved far less useful, in terms of participation.

[Availability and services of dentists under pressure?]

Signals in society point to a shortage of dentists in the Netherlands. Aim of this study is to explore how patients, against the background of supposed shortage, judge the availability and services of dentists. For this research the 'Consumerspanel Health Care', in which 1.395 persons participate, was asked to complete a postal questionnaire. Response rate was 73.8%. Results show that there are presently no serious problems for patients with the services of dentist due to the presumed lack of dentists. The patients were very satisfied with the accessibility and the services delivered by the dentists in the Netherlands. With the availability there seem to be some possible problems.

Quality of health care in inflammatory bowel disease: development of a reliable questionnaire (QUOTE-IBD) and first results

OBJECTIVES

As inflammatory bowel disease is a chronic disorder, usually with an early onset in life, quality of care plays an important role for patients. The aim of this study was to develop a questionnaire to measure quality of care through the eyes of patients with inflammatory bowel disease.

METHODS

Ten generic questions were already available because the questionnaire is based on an existing instrument. Patients with inflammatory bowel disease in seven countries were involved in the development of additional disease-specific items. Validation and first field testing of the total questionnaire (QUOTE-IBD) was performed in The Netherlands.

RESULTS

A total of 380 patients cooperated in the development of 13 disease-specific items, with high internal reliability (Cronbach's alpha = 0.83). Another 162 patients were involved in validating and testing of the QUOTE-IBD, which consists of 23 items in total. Pearson's correlation coefficient between QUOTE-IBD and visual analog scale scores of health care items was 0.55. Intraclass correlation coefficient of two assessments was 0.64. First testing showed that patients gave relatively poor marks to some part of health care services, such as providing information about extraintestinal complaints and the psychological as well as physical approach to complaints.

CONCLUSIONS

A short, valid, reliable questionnaire was developed to measure the opinions of patients with inflammatory bowel disease on quality of health care. The QUOTE-IBD can be used for identification of areas for improvement, with the aim of optimizing health care in inflammatory bowel disease.

'Burnout' among Dutch midwives

OBJECTIVE

to determine the effect of workload on 'burnout' having considered work capacity.

DESIGN

cross-sectional study.

SETTING

Dutch community midwives in independent practice.

PARTICIPANTS

200 Dutch community midwives.

MEASUREMENTS

three-week diary recordings, a questionnaire on practice and personal characteristics, and a questionnaire on 'burnout', social support and coping style.

FINDINGS

differences in 'burnout' can be explained partly by the midwife's workload and partly by her work capacity. A high workload may lead to 'burnout' when a midwife is unable to handle stressful situations.

KEY CONCLUSIONS

when a higher percentage of the supervised births occurred at the client's own home instead of during a short-stay hospital visit, the chances of 'burnout' are lower.

IMPLICATIONS FOR PRACTICE

changes in the organisation of Dutch community midwifery care may contribute to the reduction of 'burnout'. 'Burnout' is a complex phenomenon influenced both by individual and organisational factors. When formulating policy to reduce 'burnout' among midwives specific work-related factors must be considered and emphasis be placed on the importance of personal resources.

Quality of care and patient satisfaction: a review of measuring instruments

Surveying the literature on the assessment of quality of care from the patient's perspective, the concept has often been operationalized as patient satisfaction. Patient satisfaction has been a widely investigated subject in health care research, and dozens of measuring instruments were developed during the past decade. Quality of care from the patient's perspective, however, has been investigated only very recently, and only a few measuring instruments have explicitly been developed for the assessment of quality of care from the patient's perspective. The authors consider patient satisfaction as an indicator of quality of care from the patient's perspective. This review is concerned with the question of whether any reliable and valid instruments have been developed to measure quality of care from the patient's perspective.