Development of a patient-reported outcome measure of recovery after abdominal surgery: A conceptual framework
Notice bibliographique
Résumé
Background: The use of patient-reported outcome measures (PROMs) are central for delivering high-quality patient-centered care to postoperative patients. However, the evidence underpinning the measurement properties of PROMs currently in use to measure recovery after abdominal surgery is weak. To bridge this knowledge gap, we initiated a research program to develop a conceptually relevant and psychometrically sound recovery-specific PROM. In compliance with best-practice recommendations for PROM development, this thesis project aimed to develop a conceptual framework representing the health domains relevant to the process of recovery after abdominal surgery. Methods:This study was conducted in two parts: Part 1 (Manuscript 1): A hypothesized conceptual framework of recovery was developed based on literature review and expert opinion. Firstly, a systematic review was undertaken to identify PROMs currently used in the context of recovery after abdominal surgery. All items contained in the PROMs were categorized into health domains covered by the International Classification of Functioning, Disability and Health (ICF). To acquire expert input, 35 perioperative care experts from major surgical societies in North America and Europe were invited to participate in a 2-round Delphi study in which they rated their agreement with each domain. Domains deemed as relevant (>75% agreement) were organized into a diagram comprising a hypothesized conceptual framework of recovery after abdominal surgery. Part 2 (Manuscript 2): A final conceptual framework of recovery was developed based on patient input. Patients from 4 different countries (Canada, Italy, Brazil and Japan) participated in qualitative interviews focusing on their lived experiences of recovery after abdominal surgery. Interviews were guided by the previously developed hypothesized framework. Interviews were analyzed according to a modified grounded theory approach and transcripts were coded according to the ICF. Codes for which thematic saturation was reached were classified into domains of health that are relevant to the process of recovery after abdominal surgery. These domains were organized into a structured diagram. Results:Part 1 (Manuscript 1): The systematic review identified 19 PROMs covering 66 ICF domains. 23 experts (66%) participated in the Delphi process. After Round 2, experts agreed that 22 ICF health domains are potentially relevant to the process of recovery after abdominal surgery. Part 2 (Manuscript 2): 30 patients with diverse demographics and surgical characteristics were interviewed (50% male, age 57±18 years; 66% major or major extended surgery). 39 unique domains of recovery emerged from the interviews, 17 falling under the ICF category of "Body Functions" and 22 under "Activities and Participation". These domains constitute the final conceptual framework of recovery after abdominal surgery.Conclusion:The research reported in this thesis provides comprehensive insight into the health domains that are relevant to the process of recovery after abdominal surgery. This conceptual framework will support content validity and provide the pivotal basis for the development of a novel PROM to inform patient-centered research and quality improvement initiatives in abdominal surgery
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».