1. User-Centered Design of the consideRATE Questions, a Measure of People's Experiences When They Are Seriously Ill
- Author
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Amber E. Barnato, Joan Collison, Meredith MacMartin, Glyn Elwyn, Garrett Wasp, Catherine H. Saunders, Ashleigh Jaggars, Tanya Butt, Kathryn B. Kirkland, Eugene C. Nelson, David Wilson Milne, Marie-Anne Durand, and Peter Scalia
- Subjects
Palliative care ,business.industry ,Communication ,Illness experience ,Sample (statistics) ,Context (language use) ,Cognition ,Phase (combat) ,Article ,03 medical and health sciences ,0302 clinical medicine ,Anesthesiology and Pain Medicine ,Caregivers ,Nursing ,030220 oncology & carcinogenesis ,Humans ,Medicine ,Family ,030212 general & internal medicine ,Neurology (clinical) ,Completion time ,business ,User-Centered Design ,General Nursing ,User-centered design - Abstract
Context No brief patient-reported experience measure focuses on the most significant concerns of seriously ill individuals. Objectives The objective of the study was to develop the consideRATE questions. Methods This user-centered design study had three phases. We reviewed the literature and consulted stakeholders, including caregivers, clinicians, and researchers, to identify the elements of care most important to patients (Phase 1). We refined items based on cognitive interviews with patients, families, and clinicians (Phase 2). We piloted the measure with patients and families (Phase 3). Results Phase 1 resulted in seven questions addressing the following elements: 1) care team attention to patients' physical symptoms, 2) emotional symptoms, 3) environment of care, 4) respect for patients' priorities, 5) communication about future plans, 6) communication about financial and similar affairs, and 7) communication about illness trajectory. Phase 2 participants included eight patients, eight family members, and seven clinicians. We added an open-text comment option. We did not identify any other issues that were important enough to participants to include. Response choices ranged from one (very bad) to four (very good), with a not applicable option (does not apply). Phase 3 involved 15 patients and 16 family members and demonstrated the acceptability of the consideRATE questions. Most reported that the questions were not distressing, disruptive, or confusing. Completion time averaged 2.4 minutes (range 1–5). Conclusion Our brief patient-reported serious illness experience measure is based on what matters most to patients, families, and clinicians. It was acceptable to patients and families in a regional sample. It has promise for use in clinical settings.
- Published
- 2021