共查询到20条相似文献,搜索用时 11 毫秒
1.
W. Chr. Kleijn K. Ogoshi K. Yamaoka T. Shigehisa Y. Takeda C. L. Creutzberg J. W. R. Nortier A. A. Kaptein 《Quality of life research》2006,15(6):1091-1101
Research into the equivalence of Western and Japanese conceptualizations of health-related quality of life (HR-QOL) is scarce.
We used the Western (European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30) and the Japanese (HRQoL-20)
questionnaire in order to analyze the conceptual similarity of HR-QOL factors, and the associations between specific symptom
items with overall HR-QOL in Japanese (n = 265) and Dutch (n = 174) patients with various types of cancer. Both populations
completed both instruments. In both patient groups, the overall health scale of the EORTC-QLQ-C30 correlated highly (r = 0.59; p < 0.001) with the HRQOL-20 composite average score, indicating substantial conceptual comparability. Relationships between
all EORTC-QLQ-C30 symptom items with HR-QOL were examined by ranking their correlations with the two overall measures of HR-QOL.
Comparable patterns in the Japanese and Dutch samples were observed. The results suggest a considerable conceptual equivalence
of HR-QOL in Japanese and Dutch cancer patients, and indicate a satisfactory structural and cross-cultural equivalence for
the EORTC-QLQ-C30 with regard to items measuring functioning and specific symptoms. Longitudinal studies are needed to examine
the impact of specific symptoms on general quality of life. 相似文献
2.
This study investigates efficiency and quality of care in nursing homes. By means of Data Envelopment Analysis (DEA), the
efficiency of 40 nursing homes that deliver their services in the north-western area of the Lombardy Region was assessed over
a 3-year period (2005–2007). Lombardy is a very peculiar setting, since it is the only Region in Italy where the healthcare
industry is organised as a quasi-market, in which the public authority buys health and nursing services from independent providers—establishing
a reimbursement system for this purpose. The analysis is conducted by generating bootstrapped DEA efficiency scores for each
nursing home (stage one), then regressing those scores on explanatory variables (stage two). Our DEA model employed two input
(i.e. costs for health and nursing services and costs for residential services) and three output variables (case mix, extra
nursing hours and residential charges). In the second-stage analysis, Tobit regressions and the Kruskall–Wallis tests of hypothesis
to the efficiency scores were applied to define what are the factors that affect efficiency: (a) the ownership (private nursing
houses outperform their public counterparts); and (b) the capability to implement strategies for labour cost and nursing costs
containment, since the efficiency heavily depends upon the alignment of the costs to the public reimbursement system. Lastly,
even though the public institutions are less efficient than the private ones, the results suggest that public nursing homes
are moving towards their private counterparts, and thus competition is benefiting efficiency. 相似文献
3.
D H Gustafson C J Fiss J C Fryback P A Smelser M E Hiles 《Public health reports (Washington, D.C. : 1974)》1980,95(4):336-343
The traditional method of evaluating nursing homes, which relies on State and Federal regulations, does not ensure quality care for nursing home residents. This fact led the Wisconsin State Department of Health and Social Services to fund a project for the development of a system that would permit rapid and reliable assessment of the quality of care given by nursing homes, permit the identification of specific problem areas, and suggest whether more in-depth investigation was needed. A corner-stone in that system was to be a screening instrument that would quickly determine where the care delivery system in a nursing home was breaking down so that resources could be focused on these problem areas.Eleven quality of care criteria to be used in the screening instrument were drawn up by a panel of experts. The instrument itself was then tested in nine Wisconsin nursing homes. Five teams of people with nursing home expertise (two persons per team) used the screening instrument to evaluate each of the homes. Another team, visiting the same homes, used a second screening instrument based on State and Federal regulations to evaluate the homes. Finally, without relying on any survey instrument, all of the teams did a general assessment of the homes. The purpose of this general assessment was to ascertain if a "common wisdom" exists among experts in the field. The results of the teams' evaluations using both instruments were compared with each other, as well as with the results of the general assessments and the results of the most recent standard survey. This analysis showed that there was a significant amount of inter-team reliability among the teams using the new screening model and, also, that the new screening model correlated well with the general assessments.The model is being tested further in a 2-year study of 170 nursing homes in urban and rural parts of Wisconsin. 相似文献
4.
J L Barney 《American journal of public health》1974,64(3):265-268
5.
The purpose of this study was to investigate and analyze the moral tension that exists in the care for demented nursing home patients, between the principle of respect for autonomy and the value that is attached to respect for the subjective world of the patient. To this end an ethnographical field study was carried out by two researchers in two Dutch nursing homes. Among the central topics that evolved were the different moral problems that nurses experience concerning truth telling and acting truthfully in relation to demented patients. In situations unrelated to the dementia and its diagnosis, the right to be informed is in principle respected, even if the information is sometimes painful. More specific questions of demented patients about their situation are a regular cause of embarrassment for their carers, who rely on various treatment strategies to deal with such questions. These strategies are often successful. However, when they fail, the nurses are faced with a problem they cannot solve, namely the loss of a common shared world and the resulting unmentionable truth about the diagnosis of dementia, as objective basis and legitimization for their approach to the demented patient. We conclude that in the training and professional support given to nurses, more attention should be paid to (awareness of) the moral problems that arise from this loss of a common shared world, so that they can react to the subjective world of demented patients without feeling that they are deceiving them. 相似文献
6.
Describes a study of three community nursing services provided by North Staffordshire Health Authority, which was carried out during the summer of 1991. Both the type and focus of quality measurement reported here are fairly unique. While the development of quality measures is yet at an early stage, most measures to date are quantitative. These can inform about volume of use of a service, but not its quality. The measures designed for this study were qualitative. These, when combined with quantitative data (statistics, routinely collected), yield much richer and more complete information as a basis for decision making in service planning. Quality data on the use of community services are also under-represented in the quality literature--most studies to date have used hospital patient services as their source for data collection. Goes some way towards redressing the imbalance. 相似文献
7.
Background
The Investigating Choice Experiments for the Preferences of Older People (ICEPOP) programme developed a capability-based measure of general quality of life (QOL): the ICEPOP CAPability (ICECAP-O) instrument. ICECAP-O was originally intended for use in the economic evaluation of health and social care interventions, but there is increasing interest in using it to quantify differences in QOL in cross-sectional data.Objective
The objective of this study was to assess the construct validity of the overall ICECAP-O scores and quantify differences in QOL associated with various factors in a multivariable regression model among residents of a British city.Methods
ICECAP-O was administered as part of a survey of 4304 citizens of a British city. QOL values in only those respondents aged ≥65 years (n= 809) were compared across subgroups using univariable analyses and multivariable regression models.Results
QOL values were associated with differences in responses to a variety of questions about respondents’ socioeconomic status, locality, contact with others, participation, health and social support. Multivariable regression results showed that poor physical and psychological health were associated with 4–7% lower QOL. Living alone and infrequent socializing were each associated with an approximately 2.5% impairment in QOL. Feeling unsafe after dark was associated with an 8% impairment, whilst those without a faith experienced 5% lower QOL on average. Distribution of ICECAP-O values by electoral ward enabled the identification of areas of deprivation, although the associations were strong only for enjoyment and control.Conclusion
ICECAP-O provides policy makers with robust quantitative evidence of differences in QOL. It offers local government an opportunity to evaluate the effects of health and other interventions, and to make comparisons across sectors for which it is responsible. It also demonstrates good ability to compare impairments in QOL associated with sociodemographic, health and attitudinal variables. 相似文献8.
Li Junling Xu Xueying Sun Jinbin Cai Weijie Qin Tiantian Wu Mingcheng Liu Hongbo 《Quality of life research》2020,29(11):2949-2960
Quality of Life Research - This study aimed to explore the current status of activities of daily living (ADLs), life orientation, and health-related quality of life (HRQoL) among older people in... 相似文献
9.
The primary objective of this paper is to examine the cost structure of the Dutch nursing home industry, using econometric techniques. In this paper we present a model that combines economic behaviour and quality of services measured by a latent variable. We propose a simple method for identifying and estimating cost functions in the presence of endogenous, unobserved quality. Estimating this quality-adjusted cost function and the corresponding cost share equations indicates that quality is negatively related to the input prices of nurses and other personnel, indicating that nursing homes have a preference for labour. We also show that the quality-adjusted model is superior to a model with exogenous quality. 相似文献
10.
Marielle C.J.L. Klerks Corry A.J. Ketelaars Paul B.M. Robben 《Health policy (Amsterdam, Netherlands)》2013
Politicians and regulators have high expectations of unannounced inspections. Unannounced inspections, unlike announced ones, would, they believe, lead to a clearer insight into the risks and a reduction of the regulatory burden. In order to verify these assumptions, a systematic review of the scientific literature and an exploratory study were conducted. In the systematic review only three relevant articles were found concerned with research into the difference between unannounced and announced inspections. In the exploratory study, Dutch nursing homes were inspected, unannounced, and later announced, in order to compare the risks detected during the inspections. It is concluded that unannounced inspections did not reveal more or different risks, but provided a better insight into the quality of care delivered. Announced inspections are the best option for the assessment both of the organization and of its preconditions for good care. Evidence was found that an unannounced inspection leads to a reduction of the regulatory burden. 相似文献
11.
Junge Stefan Gellert Paul O’Sullivan Julie Lorraine Möller Sebastian Voigt-Antons Jan-Niklas Kuhlmey Adelheid Nordheim Johanna 《Quality of life research》2020,29(6):1721-1730
Quality of Life Research - Our aim was to examine whether quality of life which was repeatedly assessed over time is related with the comprehensive assessment of quality of life (QoL) and thereby... 相似文献
12.
Boersma-van Dam Elise van de Schoot Rens Hofland Helma W. C. Engelhard Iris M. Van Loey Nancy E. E. 《Quality of life research》2021,30(3):737-749
Quality of Life Research - This study explored the individual trajectories of health-related quality of life (HRQL) compared to recalled pre-burn level of HRQL and investigated whether burn... 相似文献
13.
Determinants of global quality of life before and after major cancer surgery: an exploratory study 总被引:1,自引:0,他引:1
Martin Ruteg?rd Rachael Hughes Pernilla Lagergren Jane M. Blazeby 《Quality of life research》2009,18(9):1131-1136
Objective
To explore whether determinants of global quality of life (QOL) change before and after major cancer surgery. 相似文献14.
BACKGROUND: The need for quality improvement and increasing concern about the costs and appropriateness of health care has led to the implementation of quality systems in healthcare organisations. In addition, nursing homes have made significant investments in their development. The effects of the implementation of quality systems on health related outcomes are not yet clear. OBJECTIVE: To examine evidence in the literature on whether quality systems have an impact on the care process and the satisfaction and health outcomes of long term care residents. METHODS: Review of the literature. RESULTS: The 21 empirical studies identified concerned quality system activities such as the implementation of guidelines; providing feedback on outcomes; assessment of the needs of residents by means of care planning, internal audits and tuition; and an ombudsman for residents. Only four articles described controlled studies. The selected articles were grouped according to five focal areas of quality. The opinion of residents was seldom used to evaluate the effectiveness of quality systems. The effects on care processes and the health outcomes of long term care residents were inconsistent, but there was some evidence from the controlled studies that specific training and guidelines can influence the outcomes at the patient level. CONCLUSIONS:The design of most of the studies meant that it was not possible to attribute the results entirely to the newly implemented quality system. As it is difficult in practice to design a randomised controlled study, future research into the effectiveness of quality systems should not only focus on selected correlates of quality, but should also include a qualitative and quantitative (multivariate and multilevel) approach. The methods used to measure quality need to be improved. 相似文献
15.
Debby Lydia Gerritsen Nardi Steverink Marcel E. Ooms Henrica C. W. de Vet Miel W. Ribbe 《Quality of life research》2007,16(6):1029-1037
Measuring quality of life is a necessity for adequate interventions. This paper concerns the usefulness of six self-report
measures for overall quality of life for nursing home residents with various levels of cognitive impairment. It was investigated
which proportion of residents from four cognition groups could complete a scale, and internal consistency and construct validity
of the scales were studied. Data collection took place in ten Dutch nursing homes (N = 227). The proportion of residents that could complete each scale varied. The Depression List could be administered most
often to the cognitively most impaired group (43%; Mini Mental State Examination-scores 0–4). In the three cognition groups
with MMSE-score >5, internal consistency of the Depression List, Geriatric Depression Scale and Negative Affect Scale was
adequate in all three groups (alpha ≥.68). Intercorrelation was highest for the Philadelphia Geriatric Center Morale Scale,
the Depression List, and the Geriatric Depression Scale (rho ≥.65). Nonetheless, self-report scales were not strongly correlated
with two observational scales for depression, especially in cognitively severely impaired residents (rho ≤.30). In conclusion,
it may not be possible to measure overall quality of life through self-report, and possibly also through observation, in many
nursing home residents. 相似文献
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18.
K. M. Taylor K. G. Macdonald A. Bezjak P. Ng A. D. DePetrillo 《Quality of life research》1996,5(1):5-14
There is an implicit assumption that physicians incorporate quality of life (QOL) information in clinical decision-making. However, very limited data exists on how physicians view QOL information and how they actually use it. To explore this issue, an in-depth study was conducted using a semistructured interview guide, with 60 oncologists in Canada and the USA. While the majority of respondents perceived QOL as important they reported a tendency to use it informally and not in all situations. Key findings include the belief expressed by 88% of respondents that the term QOL could be defined, although they differed in their definitions. Although 85% stated that QOL can be formally measured, only a third perceived that the current instruments provide valid and reliable data. Respondents noted a number of significant benefits and drawbacks of using QOL data in their clinical practice that had not been previously noted in the literature. For example, its use as an endpoint in clinical trials was generally perceived to enhance both physician and patient participation. A drawback noted was that including QOL might adversely affect the decision-making process. These findings have been used to develop a self-administered questionnaire (MD-QOL) which will test the generalizability of these findings. 相似文献
19.
Liane Schenk Roger Meyer Anja Behr Adelheid Kuhlmey Martin Holzhausen 《Quality of life research》2013,22(10):2929-2938