The outcomes process: Some reflections from research with people in their 60s and 70s

Hill, Sara; Harries, Ursula

doi:10.1080/09581599308406909

Cited by 9 publications

(4 citation statements)

References 4 publications

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“…Evidence that quantitative approaches are in danger of preempting patient responses can be taken from outside of palliative care. In their study, which is significant for our purposes, Hill and Harries (13) interviewed patients after cataract surgery using both the Medical Outcomes Study Short Form-36 (SF-36) and semi-structured interviews. The SF-36 aims to measure individuals' own perceptions of their health.…”

Section: Appropriate Methodologiesmentioning

confidence: 99%

Health Outcomes for People who use Palliative Care Services

Devery

Lennie²,

Cooney³

1999

J Palliat Care

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Health outcomes are being promoted as a necessary evaluation measure in health care services. Less often discussed is the notion that health outcomes are artificially designated endpoints and that different people in the health system have different ideas of what the outcomes ought to be. Whose evidence is acceptable and relevant in constructing a framework of health outcomes in palliative care? This paper presents the findings of a research project undertaken in New South Wales, Australia, on health outcomes as evaluated by patients and caregivers. A wide range of health care professionals also participated. Patients and caregivers valued outcomes or endpoints in palliative care that were not necessarily brought about by expert clinical intervention. By adopting too narrow an interpretation of outcomes we risk sacrificing that which is uniquely valuable in palliative care services.

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Section: Appropriate Methodologiesmentioning

confidence: 99%

Health Outcomes for People who use Palliative Care Services

Devery

Lennie²,

Cooney³

1999

J Palliat Care

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“…However, the most relevant evidence on content validity arises from interviews of informants about their experience of completing standardized questions. Problems that may be reported include informants' difficulty in understanding the questions, their need to seek frequent clarification over meaning and possible interpretation, or their finding the questions to be irrelevant and not to address their own ill-health situation (Donovan et al 1993;Hill & Harries 1993).…”

Section: Patient Centrednessmentioning

confidence: 99%

Monitoring outcomes in routine practice: defining appropriate measurement criteria

Long

Dixon

1996

Evaluation Clinical Practice

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With the development of an internal market for health care, 'purchasing for outcomes' has become an important if somewhat rhetorical catchphrase. While there is emerging understanding about how it can be pursued, doubts are being expressed over an outcomes rather that a process emphasis. This debate has been confused by a failure to differentiate the role and importance of monitoring outcomes at an individual patient care level from those at an aggregate population/purchaser level. The clinical need to collect outcomes data on individual patient care within routine care settings places additional requirements on measurement development and selection. Traditional measurement criteria, stressing reliability, validity and responsiveness to change, must be supplemented by criteria of feasibility of use, clinical utility and acceptability. One option is to select domains or items of interest from longer instruments initially designed for research, carefully selected in relation to the purposes of measurement. Further measurement criteria must be addressed which stress the relevance of the proposed instrument to the condition and to the participants in the clinical interaction: in particular, patient-centredness and sensitivity to the setting. Monitoring the outcomes of individual patient care within routine clinical practice poses considerable challenges to researchers who are developing instruments and to clinicians who collect and use the data. A shift in emphasis is required towards more context-specific tests, addressing relevance to lay perceptions, to clinical use and to the condition and setting under review. The content validity, the responsiveness to patient-relevant and clinically relevant change and, of course, reliability must have greater primacy. In this way, outcome data which measure the quality of clinical practice and which provide appropriate criteria for research into effectiveness can be generated.

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“…These efforts have been assessed by different means, but not always with satisfactory results (5). According to previous qualitative work, generic quality of life (QoL) instruments do not necessarily cover important aspects of life that might be affected by the intervention under study (6–8). In addition to generic and disease‐specific QoL instruments, the construction of an instrument specific for pharmacy services has been proposed (9).…”

Section: Introductionmentioning

confidence: 99%

“…It is important that the ways in which respondents interpret the items on the scale and retrieve, calculate and format that answer, do not produce unwanted noise in the final measurement (17, 18). To study these issues, methods that produce large quantities of information about the instrument, compared to the effort and number of study participants required, are needed; hence qualitative interview techniques can be useful (6, 7, 19–22). Emanating from the fields of social and cognitive psychology, a range of techniques called CASM (Cognitive Aspects of Survey Methodology) produces valuable data (17, 18, 23, 24).…”

Section: Introductionmentioning

confidence: 99%