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准入、关系、质量和安全(ARQS):一项定性研究,旨在共同创建一个用于虚拟初级保健的原住民患者体验工具。

Access, Relationships, Quality and Safety (ARQS): a qualitative study to cocreate an Indigenous patient experience tool for virtual primary care.

机构信息

Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

出版信息

BMJ Open Qual. 2023 Dec 7;12(4):e002365. doi: 10.1136/bmjoq-2023-002365.

Abstract

BACKGROUND

Perspectives from Indigenous peoples and their primary care providers about the quality and impacts of virtual primary care for Indigenous patients are currently limited. This study engaged Indigenous patients and their primary care providers, resulting in four domains being established for an Indigenous patient experience tool for use in virtual primary care. In this paper, we explore the development and finalisation of the Access, Relationships, Quality and Safety (ARQS) tool.

METHODS

We re-engaged five Indigenous patient participants who had been involved in the semistructured interviews that established the ARQS tool domains. Through cognitive interviews, we tested the tool statements, leading to modifications. To finalise the tool statements, an Indigenous advisory group was consulted.

RESULTS

The ARQS tool statements were revised and finalised with twelve statements that reflect the experiences and perspectives of Indigenous patients.

DISCUSSION

The ARQS tool statements assess the four domains that reflect high-quality virtual care for Indigenous patients. By centring Indigenous peoples and their lived experience with primary care at every stage in the tool's development, it captures Indigenous-centred understandings of high-quality virtual primary care and has validity for use in virtual primary care settings.

CONCLUSION

The ARQS tool offers a promising way for Indigenous patients to provide feedback and for clinics to measure the quality and safety of virtual primary care practice on the provider and/or clinic level. This is important, as such feedback may help to promote improvements in virtual primary care delivery for Indigenous patients and more widely, may help advance Indigenous health equity.

摘要

背景

目前,关于原住民患者对虚拟初级保健的质量和影响的观点,来自原住民和他们的初级保健提供者的观点有限。本研究让原住民患者及其初级保健提供者参与进来,因此为虚拟初级保健中使用的原住民患者体验工具确定了四个领域。在本文中,我们探讨了 Access、Relationships、Quality 和 Safety(ARQS)工具的开发和最终确定。

方法

我们重新联系了五名参与确定 ARQS 工具领域的半结构化访谈的原住民患者参与者。通过认知访谈,我们测试了工具陈述,导致了修改。为了最终确定工具陈述,咨询了一个原住民咨询小组。

结果

经过修订和最终确定了十二项工具陈述,反映了原住民患者的体验和观点。

讨论

ARQS 工具陈述评估了反映原住民患者虚拟护理高质量的四个领域。通过在工具开发的每个阶段都以原住民人民及其在初级保健方面的生活体验为中心,它捕捉到了原住民对虚拟初级保健高质量的理解,并具有在虚拟初级保健环境中使用的有效性。

结论

ARQS 工具为原住民患者提供了一种反馈的方式,也为诊所提供了衡量虚拟初级保健实践的质量和安全性的方法,无论是在提供者还是诊所层面。这一点很重要,因为这种反馈可能有助于促进虚拟初级保健为原住民患者提供更好的服务,更广泛地说,可能有助于促进原住民健康公平。

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本文引用的文献

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