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Scoping review of patient- and family-oriented outcomes and measures for chronic pediatric disease

机译:面向患者和家庭的慢性儿科疾病预后评估和措施范围界定

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Background Improvements in health care for children with chronic diseases must be informed by research that emphasizes outcomes of importance to patients and families. To support a program of research in the field of rare inborn errors of metabolism (IEM), we conducted a broad scoping review of primary studies that: (i) focused on chronic pediatric diseases similar to IEM in etiology or manifestations and in complexity of management; (ii) reported patient- and/or family-oriented outcomes; and (iii) measured these outcomes using self-administered tools. Methods We developed a comprehensive review protocol and implemented an electronic search strategy to identify relevant citations in Medline, EMBASE, DARE and Cochrane. Two reviewers applied pre-specified criteria to titles/abstracts using a liberal accelerated approach. Articles eligible for full-text review were screened by two independent reviewers with discrepancies resolved by consensus. One researcher abstracted data on study characteristics, patient- and family-oriented outcomes, and self-administered measures. Data were validated by a second researcher. Results 4,118 citations were screened with 304 articles included. Across all included reports, the most-represented diseases were diabetes (35%), cerebral palsy (23%) and epilepsy (18%). We identified 43 unique patient- and family-oriented outcomes from among five emergent domains, with mental health outcomes appearing most frequently. The studies reported the use of 405 independent self-administered measures of these outcomes. Conclusions Patient- and family-oriented research investigating chronic pediatric diseases emphasizes mental health and appears to be relatively well-developed in the diabetes literature. Future research can build on this foundation while identifying additional outcomes that are priorities for patients and families.
机译:背景信息慢性病儿童医疗保健的改善必须以强调对患者和家庭重要的结果的研究为基础。为了支持罕见的先天性新陈代谢错误(IEM)领域的研究计划,我们对主要研究进行了范围广泛的回顾:(i)在病因或表现以及管理复杂性方面着眼于类似于IEM的慢性儿科疾病; (ii)报告的以患者和/或家庭为导向的结果; (iii)使用自我管理的工具衡量了这些结果。方法我们制定了全面的审查协议并实施了电子搜索策略,以识别Medline,EMBASE,DARE和Cochrane中的相关引用。两位审稿人使用自由加速方法将预先指定的标准应用于标题/摘要。由两名独立审稿人筛选符合全文检索条件的文章,并通过共识解决差异。一位研究人员提取了有关研究特征,以患者和家庭为导向的结果以及自我管理措施的数据。数据由另一位研究人员验证。结果对4,118篇文献进行了筛选,包括304篇文章。在所有纳入的报告中,代表最多的疾病是糖尿病(35%),脑瘫(23%)和癫痫病(18%)。我们从五个新兴领域中识别出43种以患者和家庭为导向的独特结局,其中心理健康结局出现频率最高。研究报告使用了405项独立的自我管理措施来评估这些结果。结论研究慢性儿童疾病的以患者和家庭为导向的研究强调心理健康,并且在糖尿病文献中似乎相对发达。未来的研究可以在此基础上发展,同时确定患者和家属优先考虑的其他结果。

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