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Copy of Blackboard [Template]

How someone early in their career can take the right steps to get to the next level
by

Monica Hadi

on 30 September 2013

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Transcript of Copy of Blackboard [Template]

The Development of a patient-centred questionnaire for people with chronic conditions:
"Your Experiences of Care in Long-Term Conditions"
Main Idea
Development of a generic patient-centred questionnaire for people with chronic conditions, aiming to capture:
Health care experiences
Outcomes
Quality of care
Monica Hadi

BSc, MSc, PhD
Department of Primary Care Health Sciences

Elizabeth Gibbons, Advisor
Department of Public Health

Background and Rationale
Improving patient experience
Positive patient experience (Transparency in Outcomes, DH, 2010)
Patient-centred care - putting the patient at the centre of their care

Long-term conditions
Enhancing QoL for people with LTCs (Equity & Excellence, DH, 2010)
Quality of care remains variable across different LTC (Goodwin et al. 2010)
Suggestion for the development of a measure of quality
Filter applied to analysis
Capabilities Approach
Aspects of care that allow people to live well with health problems, which cannot be fully cured


Methods of Development
Analysis of 100 patient interviews, 5 chronic conditions;
Rheumatoid arthritis
Diabetes type 2
Asthma
Heart failure
Epilepsy
Critical Interpretive Synthesis
Secondary Qualitative Analysis
"Extensive literature review examining recognised health care quality and patient-centred care frameworks to create higher domains of care"
To capture patients' perspective of health care delivery
Thank you for listening!
Monica.Hadi@phc.ox.ac.uk
What do people with LTCs think is important?
What does literature say is important?
Questionnaire Development
Cognitive Debriefing Interviews
Interactions
Communication
Information & Education
Responsiveness to individual needs
Patient involvement
Relationship with health professionals
Structure & Process
Access & Availability
Environment
Consistency, Continuity & Co-ordination
Monitoring health
Outcomes of Care
Effectiveness

Maintenance & Control

Expectations

Competence of health professionals
Rather than going into the surgery and waiting and then having a ten minute appointment you can just have a 2 minute phone call - this is how I am, is it OK to reduce down my medication?
(Patient with asthma)

There were probably really good reasons for my medication change but I sort of wanted to know it, what the reasons were rather than just being given the medication.
(Patient with arthritis)

Really part of this disease is the psychological aspect. If you had a physiotherapist say once a month “Come on”, “How are you doing?”, “What’s going on for you?”, “Why don’t you try this?” It’s much more encouraging to feel that some individual health professional is taking a genuine interest in me.
(Patient with arthritis)
The frustration of seeing a doctor you’re not used to, is the inevitable question “What medication are you taking?” and you sit there thinking, “If you turn back one page, you’ll find that it was all written down the last time I was here."
(Patient with diabetes)

I feel quite lucky that I’ve got a GP that’s allowed me to have some control over my meds. I know the minimum but I can then vary the maximum depending on how I feel.
(Patient with asthma)

Conclusion
Aims & Purpose
Understanding and acceptability

Methods
Three rounds, 30-40 minutes/interview
People with LTC & Health professionals

Outcomes
People with LTCs - Thorough and relevant across different conditions and multi-borbidity
Health professionals- relevant and helpful feedback in clinical practice




"Experience of care in LTCs"
Section 1
Your views and experiences of health care

21 items


Section 2
Demographics


5 items
Recall Period - 12 months

People with LTCs (n=25)

round 1 (n=10)
round 2 (n=15)
round 3 (n=7)

Health professionals (n=10)

round 1 (n=3)
round 2 (n=4)
round 3 (n=3)
Three sections

Section 1 - "about your LCT", 2 items
Section 2 - "views and experiences of healthcare", 5 items
Section 3 - "Demographics", 14 items
Innovative methodology for development of PROMs and PREMs
Patients as "experts" of their condition whilst recognising individual differences and health care needs
What patients themselves consider important in their care

Bringing together experiences and outcomes of care
Two concepts that are distinct yet interrelated

Good support for content validity for a generic measure for people with LTCs
Full transcript