The development of a patient concerns inventory for rheumatology outpatient clinics.
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Authors
Goff, Iain
Issue Date
2017
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Abstract
"Background: It is commonly acknowledged that medical consultations focus on the doctor’s agenda, and patients feel that their concerns are not adequately addressed. There is evidence that a patient centred approach can be beneficial both medically and by improving patient satisfaction. Patients expressed an interest in using a document to record their concerns for discussion in clinic, therefore we developed a pre-consultation questionnaire. We then set out to pilot it in the rheumatology department of a district general hospital (DGH) in order to establish whether patients found the resource helpful. We used the patient concerns inventory to form a list of common problems initially and then iteratively developed it using feedback from patients, professionals and guidance from the Year of Care Project. This process led to the refinement of the questionnaire and creation of a long and short version, both of which were compared in the study.
Methods: Patients were recruited from a DGH rheumatology clinic. For comparison and validation, the questionnaire was also piloted in stroke and diabetes clinics to identify generic themes. The questionnaire was provided in the waiting room and patients were asked to complete it and use it in their appointment. Patients were interviewed afterwards about the questionnaire and whether it had been helpful, if they would use it again and how they would improve it.
Results: Three clinics were included with 68 patients interviewed. 96% (n = 65) of patients found the questionnaire helpful and 97% (n = 66) said they would use it, suggesting that the questionnaire could be a useful resource. Patients reported that they liked the checklist style of the questionnaire, especially the longer version.
Conclusion: Patients in Northumbria described having problems expressing their concerns in clinic. The results highlighted a number of reasons for this including forgetting what concerns they wanted to raise, feeling as though no one was listening or that there was not enough time. Inventories are quick and simple to use, although they do rely on a person to have adequate reading skills. Nonetheless, their use in other specialties has been validated and their implementation in this study gained positive feedback with patients keen to take the questionnaire away with them to use in future consultations. More of the participants preferred the longer version of the inventory, as it suggested more domains of discussion that they previously had not thought about. Overall the inventory style list was found to be helpful, allowing patients to prepare for rheumatology clinics. Using the questionnaire will potentially alter the consultation style by increasing the discussion of the patient’s agenda, highlighting issues that clinicians will need to be prepared for and able to handle and will hopefully result in improved patient satisfaction and quality of care."
Description
Citation
Campbell, D. and Goff, I. (2017) 167. The development of a Patient Concerns Inventory for rheumatology outpatient clinics. Rheumatology; 56 (Suppl_2) : kex062.168
Publisher
Rheumatology
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PubMed ID
ISSN
1462-0332