护理SCI晨读：确定在儿科临床实践中使用患者报告结局的有效性

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摘要
问题：随着临床实践相关基本信息的增加，患者报告结局（PROs）在儿科临床照护领域被越来越多地认识到。然而，在综合临床证据中尚未充分探讨在儿科临床环境中使用PRO的有效性。这项研究的目的是评估在儿科临床实践中使用患者报告结局的有效性。入选标准：分别在4个英语数据库和3个中文数据库中检索从建库到2020年1月发表的有关在儿科临床实践中使用PRO的有效性研究。样本： 10篇文章符合纳入标准。结果： 10项研究的设计，样本，所用PROs（类型，长度，时间，方式）和评估结果的类型存在很大差异。评估了使用PROs对3类结果（患者，护理过程和健康服务）的影响大小。在70项测量结果中，有32项是积极的，有5项是消极的，有33项是混合的。结论：总体而言，在儿科临床实践中使用PROs具有微弱但有趋势的积极影响。启示：需要更加严格的研究设计并控制偏倚的来源，才能更直接地评估在儿科护理中使用PROs的影响。如果发现仍然是积极的，则建议运用一种考虑多种影响因素的应用模型，将PROs整合到儿科照护中。Abstract
Problem: Patient-reported outcomes (PROs) are increasingly recognized in pediatric clinical care as adding essential information relevant to actual care. However, the effectiveness of using PROs in pediatric clinical settings has not been fully explored with synthesized evidence. The aim of this study was to evaluate the effectiveness of using patient-reported outcomes in pediatric clinical practices.Eligibility criteria: We searched four English and three Chinese databases to identify studies that examine the effectiveness of using PROs in pediatric clinical practices published from the inception date of each database to January 2020.Sample: Ten articles met the inclusion criteria.Results:There was wide a variation in the ten studies' designs, samples, PROs administered (type, length, timing, mode), and type of outcomes evaluated. The effect sizes of using PROs on three categories of outcomes (patient, process of care and health service) were assessed. Of 70 measured outcomes, 32 were positive, 5 were negative, and 33 were mixed.Conclusions: Overall, there is a weak but trending positive impact of using PROs in pediatric clinical practice.Implications: More rigorous study designs with sources of bias controlled are needed to more directly assess the impact of using PROs in pediatric care. If findings continue to be positive, then an implementation model addressing the numerous influencing factors is recommended to integrate PROs into pediatric care.原文链接：

https://www.pediatricnursing.org/article/S0882-5963(20)30438-3/fulltext