出版社：Utrecht University, Maastricht University, Groningen University
摘要：Introduction : Systematic assessment of patient experience (PE) might contribute to transform the patient-professional interaction model and to improve outcomes. This type of assessments stems from the recognition of the person’s rights and, therefore, of his/her active role in their wellbeing. It is a promising alternative to the fruitless efforts of the traditional approaches to achieve patient’s participation in the design of care processes. Patient Experience describes results from the patient viewpoint when receiving care in relation to the interaction with professionals (relational aspects) and to the care process in which the person is involved (functional aspects). PE measure allows the assessment of how health and social care providers are organized to satisfy patient needs in each moment adequately. In this type of measurements, elements such as integrated care, personalized care plans, recognition of patient’s role in their own health (co-production) or communication adapted to patient’s needs and personal circumstances are crucial. IEXPAC (Instrumento de Evaluación de la eXperiencia del Paciente Crónico in Spanish, (see www.iemac.org/iexpac) is a 12 structured items scale with a 0-10 points-scale response that allows to assess the experience of a chronic patient. It has been validated in Spain considering ceiling and floor effects, reliability and face and construct validity. IEXPAC converged into 3 factors exploring: (1) the type and scope of patient and professionals interactions oriented to patient activation; (2) the patient’s self-management capacity of his/her wellbeing thanks to the interventions received and (3) new relational model of the patient with the system through internet or with partners in group interventions. This scale has its origin in the instrument IEMAC/ARCHO (Assessment of Readiness for Chronicity of Health Care Organizations, see www.iemac.org), designed to monitor progress of health and social care organizations towards an integrated, person-centered chronic care model. To facilitate the introduction of patient experience assessment in the evaluation procedures of health and social care organizations, a website was designed. IEXPAC website is accessible to patients from different profiles of users, as healthcare institutions, providers, patients’ associations or research’s teamwork. The objective of the current study was to evaluate the usefulness and user friendliness of the IEXPAC website, and the use of IEXPAC scale. Methods : The IEXPAC website (http://www.iemac.es/iexpac/default.asp) was designed for Chrome, Explorer, Safari, Firefox, Edge and to allow the introduction and recovery of data regarding one or several evaluations. Comparisons inter and intra evaluations are available so users obtain useful information to introduce changes to improve care. This website suggests recommendations about how to conduct studies in several contexts. The IEXPAC website was assessed exploring its friendliness, usefulness, and impact to introduce changes. Assessments were performed with self-assessed, online, standardized questionnaires. The number of users and downloads were also considered. Results : Preliminary results render an average rating in the IEXPAC scale of 5.7 points (SD 0.7, IC95% 3.0-3.2). Average rating for each factor is: 7.7 (SD 0.9) for factor 1; 7 (SD 0.9) for factor 2, 2.5 (SD 0.9) for factor 3. New integrated care models incorporate people’s needs, preferences and expectations. IEXPAC participates of this approach emphasizing, for instance, the need to improve patient’s active participation in their therapeutic and care plan by agreeing health targets with his/her professionals (item 6, rated 6.85, SD 1.4); facilitating information of the different health and social resources available in patient’s environment to improve their health and wellbeing (item 10, rated 5.72, SD 1.6). Capture of friendliness’ and usefulness’ data is being performed and should be finished in January 2016. Discussion : IEXPAC website is a tool that allows the assessment of Patient experience and from this measure, promoting changes in chronic care approach. The active participation of patients and the integration of all care they receive are objectives of the person-centered care that professionals and organizations strive to achieve. The new evaluative frameworks look for the integration of measures of effectiveness and efficiency together with the experience of patients. This study aims in this direction. Conclusion : The IEXPAC scale facilitates the reorientation towards person-centered care. A useful and user-friendly framework has been designed to introduce the PE measure in several health and social contexts.
关键词：patient experience measurement ; person-centred care
