Objective-To assess the sensitivity to within person change over time of an outcome measure for practitioners in primary care that is applicable to a wide range of illness.Design-Comparison of a new patient generated instrument, the measure yourself medical outcome profile (MYMOP), with the SF-36 health profile and a five point change score; all scales were completed during the consultation with practitioners and repeated after four weeks. 103 patients were followed up for 16 weeks and their results charted; seven practitioners were interviewed.Setting-Established practice of the four NHS general practitioners and four of the private complementary practitioners working in one medical centre.
Prostate cancer is the second most common cancer in men worldwide, accounting for an estimated 1.1 million new cases diagnosed in 2012 (www.globocan.iarc.fr). Currently, there is a lack of specific guidance on supportive care for men with prostate cancer. This article describes a qualitative systematic review and synthesis examining men's experience of and need for supportive care. Seven databases were searched; 20 journal articles were identified and critically appraised. A thematic synthesis was conducted in which descriptive themes were drawn out of the data. These were peer support, support from partner, online support, cancer specialist nurse support, self‐care, communication with health professionals, unmet needs (emotional support, information needs, support for treatment‐induced side effects of incontinence and erectile dysfunction) and men's suggestions for improved delivery of supportive care. This was followed by the development of overarching analytic themes which were: uncertainty, reframing, and the timing of receiving treatment, information and support. Our results show that the most valued form of support men experienced following diagnosis was one‐to‐one peer support and support from partners. This review highlights the need for improved access to cancer specialist nurses throughout the care pathway, individually tailored supportive care and psychosexual support for treatment side effects.
An outcome questionnaire that is patient-centred should encompass the aims, values and treatment effects that are prioritised by individuals, and should enable each individual to provide an unambiguous assessment of change over time. There is little evidence about how well outcome questionnaires perform in this regard. This paper describes how interviews that combined in-depth enquiry and cognitive techniques were used to explore patients' experiences of completing three outcome questionnaires over a 6 month period. The 23 interviewees all had chronic disease and were receiving acupuncture treatment for the first time. Many of the problems uncovered by this study can be ameliorated by attention to questionnaire design. For example, by the provision of at least five response options, by being explicit about including co-morbidity, and by measuring medication change as a separate outcome. The study also highlighted more fundamental conceptual difficulties, such as response shift and the respondent's conflict between scoring external function and internal distress (what they did, vs. what they felt). These issues relate to the co-existence of different perspectives and the impossibility of reducing health status to one 'single truth'. The study concludes that qualitative evaluations have an important role to play in questionnaire design and development and are likely to lead to more modest and realistic appraisals of outcome questionnaire performance.
Background: The extent to which a health care intervention causes or facilitates health-related change is a key question in research. The need to quantify such change has led to the development of an increasing number of change indicators, to measure what have come to be known as 'outcomes'. In the context of medical research into the efficacy or effectiveness of an intervention the term 'outcomes' has often been interpreted to mean single endpoints with a linear cause and effect link to an external intervention.
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