Quality of Nursing Care for Hospitalized Patients with Advanced Illness

晚期疾病住院患者的护理质量

• 批准号: 7393925
• 负责人: Shigeko Izumi
• 金额: $ 5.27万
• 依托单位: OREGON HEALTH & SCIENCE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-12-15 至 2009-12-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7393925
• 关键词: 18 year old; Academic Medical Centers; Admission activity; Adult; Advanced Malignant Neoplasm; Audiotape; Care given by nurses; Caring; Case Manager; Cessation of life; Cognitive; Condition; Data; Development; Device or Instrument Development; Diagnosis; Discipline of Nursing; Eligibility Determination; Evaluation; Goals; Health Personnel; Healthcare; Heart failure; Hospital Nursing; Hospitals; Interview; Kidney Failure; Knowledge; Letters; Life; Literature; Liver Failure; Location; Longitudinal Studies; Lung diseases; Measures; Medical Oncology; Numbers; Nurses; Operative Surgical Procedures; Outcome; Palliative Care; Participant; Patient Care; Patients; Phase; Population; Property; Psychometrics; Quality of Care; Questionnaires; Records; Recovery; Recruitment Activity; Research; Research Personnel; Review Literature; Schedule; Services; Specific qualifier value; Staging; Structure; Testing; Time; Visit; base; concept; day; flyer; improved; inclusion criteria; instrument; interest; nursing care quality; outcome forecast; patient oriented

DESCRIPTION (provided by applicant): This study's long-term objective is to improve the quality of in-hospital nursing care for patients with advanced-stage illness. The evaluation of quality in a hospital has been conducted mostly from the perspective of health care providers, while patient-centered evaluation, particularly quality evaluation by hospitalized patients with advanced illness, is largely missing. To improve the quality of nursing care for patients with advanced illness, it is vital to understand what quality nursing is for them and to have instruments that meaningfully evaluate the quality of care in this population. The specific aims of this proposal are: 1) to develop the concept of quality of nursing care from the perspective of patients with advanced illness, and 2) to develop a preliminary form of an instrument to evaluate the quality of nursing care from the perspective of patients with advanced illness. In the first phase, the concept will be developed through an extensive literature review integrated with semi-structured interviews of hospitalized patients with advanced-stage illness to identify domains and attributes. Fifteen to 25 hospitalized patients with advanced-stage illness will be recruited from adult oncology and medical-surgical units in an academic medical center. Care managers in these units will identify potential participants who meet the inclusion criteria (>18 years old with one or more of: stage IV cancer, advanced-stage lung disease, renal failure, liver failure, or heart failure). Patients will be included if they speak English, stay in the hospital >3 days, and have had at least two prior hospital admissions with any diagnosis in the proceeding 12 months. During their visits to patients, care managers will distribute a cover letter and a flyer describing the study to eligible patients. The researcher will visit interested patients to determine their eligibility for participation and schedule a time for an interview. The interview will take place in the hospital room or a location chosen by each participant. Interviews will take approximately 30 minutes, will follow an interview guide and be audiotape-recorded. Audio records will be transcribed verbatim and qualitative content analysis will be conducted. Based on the concept of quality of nursing care defined in the first phase, questionnaire items and a preliminary instrument to evaluate quality of nursing care for patients with advanced illness will be developed (phase II). Clarity and validity of this preliminary instrument will be reviewed by the health care experts and 8-12 cognitive interviews of patients with the same inclusionary conditions specified in the concept-development phase.

描述（由申请人提供）：本研究的长期目标是提高晚期疾病患者的院内护理质量。医院的质量评价大多是从医疗服务提供者的角度进行的，而以患者为中心的评价，特别是对住院晚期疾病患者的质量评价很大程度上缺失。为了提高晚期疾病患者的护理质量，了解高质量护理对他们来说意味着什么并拥有能够有效评估该人群护理质量的工具至关重要。本提案的具体目标是：1）从晚期疾病患者的角度发展护理质量的概念，2）开发从患者角度评估护理质量的工具的初步形式。患有晚期疾病的患者。在第一阶段，该概念将通过广泛的文献综述与对晚期疾病住院患者的半结构化访谈相结合来发展，以确定领域和属性。将从学术医疗中心的成人肿瘤科和内外科科室招募 15 至 25 名晚期疾病住院患者。这些单位的护理经理将确定符合纳入标准的潜在参与者（>18 岁，患有以下一种或多种疾病：IV 期癌症、晚期肺病、肾衰竭、肝衰竭或心力衰竭）。如果患者会讲英语、住院时间超过 3 天、并且在过去 12 个月内至少两次入院且有任何诊断，则将被纳入其中。在探访患者期间，护理管理人员将向符合条件的患者分发一封求职信和一张描述该研究的传单。研究人员将拜访感兴趣的患者，以确定他们的参与资格并安排访谈时间。访谈将在病房或每个参与者选择的地点进行。采访大约需要 30 分钟，将遵循采访指南并进行录音。音频记录将逐字转录，并进行定性内容分析。基于第一阶段定义的护理质量概念，将开发问卷项目和评估晚期疾病患者护理质量的初步工具（第二阶段）。该初步工具的清晰度和有效性将由医疗保健专家进行审查，并对具有概念开发阶段指定的相同包容条件的患者进行 8-12 次认知访谈。