COMPUTERIZED QOL ASSESSMENT IN LOW LITERACY PATIENTS

文化程度低的患者的计算机化生活质量评估

• 批准号: 6053791
• 负责人: ELIZABETH A HAHN
• 金额: $ 33.21万
• 依托单位: EVANSTON NORTHWESTERN HEALTHCARE RES INS
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-09-30 至 2001-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6053791
• 关键词: clinical research; computer assisted patient care; educationally disadvantaged; health care quality; health science research analysis /evaluation; health services research tag; human subject; quality of life; questionnaires

Several national organizations, including the American Medical Association, the Agency for Health Care Policy and Research, the Food and Drug Administration, and the National Institutes of Health, have stressed the need for improved health care quality indicators. The patients perspective is central to the evaluation of quality outcomes. There is an abundance of patient self-report quality of life (QOL) questionnaires that can be completed serially and used to measure improving or declining perceived health. A major barrier to success in obtaining this QOL data is the fact that over 40 million Americans are functionally illiterate, and another 50 million have marginal literacy skills (Kirsch et al, 1993). Computerized assessment of QOL outcomes, utilizing multimedia technology, may provide a simple and efficient administration method that can be easily incorporated into a busy clinical setting, with minimal burden on staff and patients. Presentation of a question on a computer screen, accompanied by a recorded reading of the same question (Audiovisual Computer-based Testing; or AVCBT) can allow people with limited or even no reading ability to participate in the assessment. A standardized approach across all levels of literacy has the added advantage of reducing the stigma of low literacy. It can also prevent the introduction of systematic method artifacts which might be present due to the mixing of modes of questionnaire administration. This project builds upon successful past and current collaborations between researchers from Evanston Northwestern Healthcare and Cook County Hospital, a public hospital serving primarily indigent, urban ethnic minorities. Specifically, we propose to: 1) Develop and evaluate AVCBT of health status and preference-based QOL outcomes for low literate, English-speaking cancer patients; and 2) Test the equivalence of QOL assessment across low and high levels of literacy. We will first develop the AVCBT platform. Then we will compare one-time AVCBT QOL assessments of 200 cancer patients who test below the seventh-grade reading level ("low literacy group") to those of 200 cancer patients who test at or above the seventh grade reading level ("high literacy group"). Rasch measurement will be used to test the equivalence of health status measurement. We hypothesize that health status items will perform similarly across literacy levels, and that after controlling for group differences in performance status, disease stage, age, gender, ethnicity and socioeconomic status, there will be no significant difference between low versus high literacy patients in AVCBT- measured QOL (both health status and preference-based).

包括美国医学协会，医疗保健政策与研究机构，食品和药物管理局以及美国国立卫生研究院在内的几个国家组织强调，需要改善医疗保健质量指标。 患者的观点对于评估质量结果至关重要。 有大量的患者自我报告生活质量（QOL）问卷可以连续完成，并用于衡量改善或下降的健康健康。 获得此QOL数据成功的主要障碍是，超过4000万美国人具有文盲，另外5000万具有边际识字能力（Kirsch等，1993）。 利用多媒体技术的QOL结果评估，可以提供一种简单有效的管理方法，可以轻松地将其纳入繁忙的临床环境中，而员工和患者负担很小。 在计算机屏幕上提出问题的介绍，并伴随着对同一问题的录制阅读（基于计算机的测试；或AVCBT），可以使具有有限甚至没有阅读能力的人参加评估。 各个识字率的标准化方法具有降低识字率低的污名的额外优势。 它还可以防止由于调查表施用模式的混合而引入可能存在的系统方法伪像。该项目建立在埃文斯顿西北医疗保健和库克县医院的研究人员之间的成功和当前合作的基础上，这是一家公立医院，主要是贫穷的城市少数民族。 具体而言，我们建议：1）开发和评估健康状况和基于偏好的质量结果的AVCBT，以识字低，讲英语的癌症患者； 2）测试低水平和高水平识字率的质量评估的等效性。 我们将首先开发AVCBT平台。 然后，我们将对200名低于七年级阅读水平（“低识字组”）的200例癌症患者进行一次性AVCBT QOL评估与200名在七年级阅读水平或高于七年级的癌症患者（“高识字组”）中的癌症患者。 Rasch测量将用于测试健康状况测量的等效性。 我们假设健康状况项目将在识字水平上相似，并且在控制了群体状况，疾病阶段，年龄，性别，种族和社会经济状况方面的群体差异之后，在AVCBT测量的QOL（健康状况和基于健康状况）中，低识字患者与高识字患者之间将没有显着差异。