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Measuring Quality (measuring + quality)
Selected AbstractsMeasuring Quality in Modern Managed CareHEALTH SERVICES RESEARCH, Issue 6p1 2003Article first published online: 18 DEC 200 First page of article [source] Measuring Quality of Life in Stroke Subjects Receiving an Implanted Neural Prosthesis for Drop FootARTIFICIAL ORGANS, Issue 5 2010Anke I. Kottink Abstract The aim was to determine if the treatment of a drop foot by means of an implantable two-channel peroneal nerve stimulator improves health-related quality of life (HRQoL). All subjects were measured at baseline and after a follow-up period of 12 and 26 weeks. Twenty-nine stroke survivors with chronic hemiplegia with drop foot who fulfilled the predefined inclusion and exclusion criteria were included in the present randomized controlled trial. The intervention group received an implantable two-channel peroneal nerve stimulator for correction of their drop foot. The control group continued using their conventional walking device, consisting of an ankle-foot orthosis, orthopedic shoes, or no device. HRQoL was assessed in two different ways: (i) by taking descriptive measures, that is, the Short Form-36 (SF-36; generic measure) and the Disability Impact Profile (DIP; specific measure); and (ii) by obtaining preference-based utilities both measured with the time trade-off (direct way) and by calculating them from the EuroQol (EQ-5D) and SF-36. A significant positive effect of the implantable device was found on the physical functioning domain, the general health domain, and the physical component summary score of the SF-36. For the DIP, a significant improvement was found on the domains mobility, self-care, and psychological status in the intervention group. Regarding the preference-based utility measures, a significant effect was found for the utility index calculated from the EQ-5D. The implantable two-channel peroneal nerve stimulator seems to be efficient to improve HRQoL, mainly the domains related to physical functioning. A relation was present between the utility indexes calculated from the EQ-5D and SF-36. [source] Measuring Quality of Care in Syncope: Case Definition Affects Reported Electrocardiogram Use but Does Not Bias ReportingACADEMIC EMERGENCY MEDICINE, Issue 1 2009Jeremiah D. Schuur MD Abstract Objectives:, The objective was to calculate agreement between syncope as a reason for visiting (RFV) an emergency department (ED) and as a discharge diagnosis (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9]), to determine whether syncope case definition biases reported electrocardiogram (ECG) usage, a national quality measure. Methods:, The authors analyzed the ED portion of the National Hospital Ambulatory Medical Care Survey (NHAMCS), 1993,2004, for patients age ,18 years. A visit was defined as being for syncope if it received one of three RFV or ICD-9 codes. Agreement between RFV and ICD-9 codes was calculated, and the percentages of syncope patients (RFV vs. ICD-9) who had an ECG were compared using chi-square and multivariate logistic regression. Results:, Raw agreement between syncope as an RFV and as an ICD-9 diagnosis code was 30.1% (95% confidence interval [CI] = 32.6% to 35.5%), representing only moderate agreement beyond chance (, = 0.50). ECG utilization was lower among visits defined by RFV (64.1%; 95% CI = 62.0% to 66.3%) than for ICD-9 diagnosis (73.6%; 95% CI = 71.4% to 75.8%). There was no meaningful variation in adjusted ECG use by patient, visit, or hospital characteristics between case definitions. Adjusted ECG use was lower under both case definitions among female patients and discharged patients and increased with age (p < 0.05). Conclusions:, Despite only moderate agreement, syncope case definition should not bias reported ECG rate by patient, visit, or hospital characteristics. Among ED patients with syncope, ECG is performed less frequently in women, a potentially important disparity. [source] Measuring quality of life in cancer survivors: a methodological review of existing scalesPSYCHO-ONCOLOGY, Issue 7 2008Nancy J. M. Pearce Abstract Background: Studies examining quality of life (QoL) in cancer survivors have relied on instruments specific to the cancer patient population. Method: MEDLINE and PsycINFO were systematically searched to identify instruments and papers reporting the psychometric qualities of relevant instruments. Two reviewers undertook data extraction with respect to reliability, validity, predictive validity, responsiveness, acceptability, readability, cross cultural acceptability and feasibility. Results: Forty-two instruments were identified. Most were either measures of general health-related QoL or developed for individuals in active treatment. Nine were developed specifically for cancer survivors. None met the rigorous psychometric standards set by the review. All established acceptable levels of validity, however, only one instrument (Quality of Life-Cancer Survivors) demonstrated adequate test,retest reliability. Acceptability, feasibility and predictive validity remain unexamined. Readability was examined in only two (Cancer Survivors' Unmet needs and Quality of Life in Adult Cancer Survivors (QLACS)). Only two instruments (QLACS and Impact of Cancer) have been developed with a wide range of cancer survivors. Generally, shorter-term cancer survivors (1,5 years) are underrepresented. Conclusion: There is a need for a psychometrically credible QoL instrument for cancer survivors who are 1,5 years post diagnosis. Copyright © 2007 John Wiley & Sons, Ltd. [source] Measuring quality of lifeBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2007J. F. Hamming Caution needed when interpreting scores [source] Validation of interactive voice response system administration of the short inflammatory bowel disease questionnaireINFLAMMATORY BOWEL DISEASES, Issue 4 2009Manuel Y. Lam BA Abstract Background: The Short Inflammatory Bowel Disease Questionnaire (SIBDQ) is a written, self-administered instrument measuring quality of life in IBD. We assessed the validity of an interactive voice response system (IVRS) as a new mode of administering the SIBDQ. Methods: An IVRS was designed using prerecorded questions to collect data via touchtone telephone. Subjects with Crohn's disease (CD) or ulcerative colitis (UC) were randomized into 2 groups with different orders of administration: written, self-administered followed by IVRS (S-I) or IVRS followed by written, self-administered (I-S). Half of the S-I group was also randomized to receive a second IVRS. Sixty-four subjects were studied: 30 in S-I, 34 in I-S. Results: The mean SIBDQ scores were not different between written and IVRS modes (P = 0.26) with r = 0.93. IVRS scores were lower in active than inactive CD (36.1 ± 9.6 versus 54.7 ± 8.6, P < 0.001) and lower in active than inactive UC (40.8 ± 9.6 versus 59.8 ± 10.0, P < 0.001). Mean scores correlated highly with disease activity indices, and were not different between first and second IVRS administrations (P = 0.85) with r = 0.92. IVRS had excellent internal consistency (Cronbach alpha = 0.90). Conclusions: IVRS administration of the SIBDQ yields results similar to written self-administration, with excellent procedural validity, test,retest reliability, and internal consistency. (Inflamm Bowel Dis 2009) [source] Patients' perceptions of the concept of the quality of care in the psychiatric setting: a phenomenographic studyJOURNAL OF CLINICAL NURSING, Issue 1 2006Agneta Schröder MSc Aim., The aim was to describe how patients perceived the concept of quality of care in psychiatric care. Background., It is important to include patients' experiences in defining quality of care and in the development of instruments measuring quality of psychiatric care, as patients have unique information. But only a limited number of studies have directly involved patients. Design., It was a qualitative interview study with 20 adult in and outpatients from psychiatric care. Method., A phenomenographic approach was used for the analysis of the interviews. Results., The results showed that quality of care was perceived as a positive concept, namely as ,good' quality of care. The normative component was striking. Five descriptive categories emerged: The patient's dignity is respected; The patient's sense of security with regard to care; The patient's participation in the care; The patient's recovery; and The patient's care environment. Two conceptions emerged that had not emerged explicitly in earlier studies of quality of care: Being helped to reduce the shame and Being looked upon as like anyone else. Conclusions., The findings emphasize the importance of the interpersonal relationship between patients and staff. There is a need for further exploration of central aspects of quality in psychiatric care. Relevance to clinical practice., It is important that the knowledge about how patients perceived the quality of care in psychiatric care is included in the planning and evaluation of care. The guidelines should designate quality of care from the patient perspective as the goal of interventions. [source] Development and validation of a questionnaire measuring quality of life in primary caregivers of children with atopic dermatitis (QPCAD)BRITISH JOURNAL OF DERMATOLOGY, Issue 3 2009K. Kondo-Endo Summary Background, Disease-specific health-related quality of life (HRQoL) instruments for primary caregivers of children with atopic dermatitis are useful in evaluating the efficacy of treatment in clinical practice and study. However, no such scale has been available in Japan. Objectives, To develop and validate a self-administered instrument specifically designed to measure quality of life in primary caregivers of children with atopic dermatitis (QPCAD). Methods, This study consisted of three successive phases: the item generation phase, pilot test phase and validation phase. In the item generation phase, questionnaire items were derived from 33 qualitative interviews with primary caregivers. In the pilot test phase, the face and content validity of the preliminary scale were assessed (n = 33). In the validation phase, the questionnaire was finalized and assessed in terms of statistical performance (n = 416). Results, The QPCAD included 19 items in the following categories: ,exhaustion', ,worry about atopic dermatitis', ,family cooperation' and ,achievement'. The reliability of internal consistency was fair (Cronbach's alpha coefficients 0·66,0·87). The QPCAD subscales and total score were significantly correlated with psychological health, physical health, anxiety, depression and severity score, with mild to moderate correlation coefficients. Test,retest reliability and responsiveness to change in severity were also satisfactory. Conclusions, The QPCAD is an appropriate tool for assessing HRQoL of primary caregivers of children with atopic dermatitis in clinical practice and clinical trials. [source] | ||||||||||