Catherine H Saunders1, Marie-Anne Durand2, Peter Scalia2, Kathryn B Kirkland3, Meredith A MacMartin4, Amber E Barnato2, David W Milne5, Joan Collison5, Ashleigh Jaggars2, Tanya Butt4, Garrett Wasp3, Eugene Nelson2, Glyn Elwyn2. 1. The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, New Hampshire, USA; Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA. Electronic address: catherinehylassaunders@gmail.com. 2. The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, New Hampshire, USA. 3. The Dartmouth Institute for Health Policy & Clinical Practice, Lebanon, New Hampshire, USA; Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA. 4. Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA. 5. Patient and Family Advisors, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
Abstract
CONTEXT: No brief patient-reported experience measure focuses on the most significant concerns of seriously ill individuals. OBJECTIVES: The objective of the study was to develop the consideRATE questions. METHODS: This user-centered design study had three phases. We reviewed the literature and consulted stakeholders, including caregivers, clinicians, and researchers, to identify the elements of care most important to patients (Phase 1). We refined items based on cognitive interviews with patients, families, and clinicians (Phase 2). We piloted the measure with patients and families (Phase 3). RESULTS: Phase 1 resulted in seven questions addressing the following elements: 1) care team attention to patients' physical symptoms, 2) emotional symptoms, 3) environment of care, 4) respect for patients' priorities, 5) communication about future plans, 6) communication about financial and similar affairs, and 7) communication about illness trajectory. Phase 2 participants included eight patients, eight family members, and seven clinicians. We added an open-text comment option. We did not identify any other issues that were important enough to participants to include. Response choices ranged from one (very bad) to four (very good), with a not applicable option (does not apply). Phase 3 involved 15 patients and 16 family members and demonstrated the acceptability of the consideRATE questions. Most reported that the questions were not distressing, disruptive, or confusing. Completion time averaged 2.4 minutes (range 1-5). CONCLUSION: Our brief patient-reported serious illness experience measure is based on what matters most to patients, families, and clinicians. It was acceptable to patients and families in a regional sample. It has promise for use in clinical settings.
CONTEXT: No brief patient-reported experience measure focuses on the most significant concerns of seriously ill individuals. OBJECTIVES: The objective of the study was to develop the consideRATE questions. METHODS: This user-centered design study had three phases. We reviewed the literature and consulted stakeholders, including caregivers, clinicians, and researchers, to identify the elements of care most important to patients (Phase 1). We refined items based on cognitive interviews with patients, families, and clinicians (Phase 2). We piloted the measure with patients and families (Phase 3). RESULTS: Phase 1 resulted in seven questions addressing the following elements: 1) care team attention to patients' physical symptoms, 2) emotional symptoms, 3) environment of care, 4) respect for patients' priorities, 5) communication about future plans, 6) communication about financial and similar affairs, and 7) communication about illness trajectory. Phase 2 participants included eight patients, eight family members, and seven clinicians. We added an open-text comment option. We did not identify any other issues that were important enough to participants to include. Response choices ranged from one (very bad) to four (very good), with a not applicable option (does not apply). Phase 3 involved 15 patients and 16 family members and demonstrated the acceptability of the consideRATE questions. Most reported that the questions were not distressing, disruptive, or confusing. Completion time averaged 2.4 minutes (range 1-5). CONCLUSION: Our brief patient-reported serious illness experience measure is based on what matters most to patients, families, and clinicians. It was acceptable to patients and families in a regional sample. It has promise for use in clinical settings.
Authors: Adam E Singer; Daniella Meeker; Joan M Teno; Joanne Lynn; June R Lunney; Karl A Lorenz Journal: Ann Intern Med Date: 2015-02-03 Impact factor: 25.391
Authors: Baohui Zhang; Alexi A Wright; Haiden A Huskamp; Matthew E Nilsson; Matthew L Maciejewski; Craig C Earle; Susan D Block; Paul K Maciejewski; Holly G Prigerson Journal: Arch Intern Med Date: 2009-03-09