Development of a New Tool for the Assessment of Patient-defined Benefit in Hospitalised Older Patients: the Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP)

Overview

Journal BMJ Open

Specialty General Medicine

Date 2020 Nov 25

PMID 33234624

Citations 2

Authors

Maria Johanna van der Kluit

Geke J Dijkstra

Barbara C van Munster

Sophia De Rooij

Affiliations

Soon will be listed here.

Abstract

Objectives: To support the shift from disease-oriented towards goal-oriented care, we aimed to develop a tool which is capable both to identify priorities of an individual older hospitalised patient and to measure the outcomes relevant to him.

Design: Mixed-methods design with open interviews, three step test interviews (TSTIs) and a quantitative field test.

Setting: University teaching hospital and a regional teaching hospital.

Participants: Hospitalised patients ages 70 years and older.

Results: The Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) consists of a baseline questionnaire and an evaluation questionnaire. Items were based on 15 qualitative interviews with hospitalised older patients. Feedback from a panel of four community-dwelling older persons resulted in some adaptations to wording and one additional item. Twenty-six hospitalised older patients participated in TSTIs with Version 1 of the baseline questionnaire, revealing indications for a good content validity and barriers in completion behaviour, global understanding and understanding of individual items, which were solved with several adaptations. Four additions were made by participants. After TSTIs with ten patients with the evaluation questionnaire, one adaptation was made. A field test with 91 hospitalised older patients revealed a small number of missing values.To enhance the feasibility, the number of items was reduced from 32 to 22, based on correlations and mean impact score. The field test was repeated with 104 other patients in a regional teaching hospital. To enhance the understanding, the tool was split into two phases. This version was tested with TSTIs with eight patients and appeared to be understandable. The final version was an interview-based tool and took about 11 min to complete.

Conclusions: The P-BAS HOP is a potentially suitable tool to identify priorities and relevant outcomes of the individual patient. Further research is needed to investigate its validity, reliability and responsiveness.

Citing Articles

Adaptation of the Patient Benefit Assessment Scale for Hospitalised Older Patients: development, reliability and validity of the P-BAS picture version.

van der Kluit M, Dijkstra G, de Rooij S BMC Geriatr. 2022; 22(1):43.

PMID: 35016639 PMC: 8751090. DOI: 10.1186/s12877-021-02708-7.

Reliability and validity of the Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP).

van der Kluit M, Dijkstra G, de Rooij S BMC Geriatr. 2021; 21(1):149.

PMID: 33648447 PMC: 7923656. DOI: 10.1186/s12877-021-02079-z.

References

Shepperd S, Iliffe S, Doll H, Clarke M, Kalra L, Wilson A . Admission avoidance hospital at home. Cochrane Database Syst Rev. 2016; 9:CD007491. PMC: 6457791. DOI: 10.1002/14651858.CD007491.pub2. View

Tinetti M, Naik A, Dindo L, Costello D, Esterson J, Geda M . Association of Patient Priorities-Aligned Decision-Making With Patient Outcomes and Ambulatory Health Care Burden Among Older Adults With Multiple Chronic Conditions: A Nonrandomized Clinical Trial. JAMA Intern Med. 2019; 179(12):1688-1697. PMC: 6784811. DOI: 10.1001/jamainternmed.2019.4235. View

Toto P, Skidmore E, Terhorst L, Rosen J, Weiner D . Goal Attainment Scaling (GAS) in geriatric primary care: a feasibility study. Arch Gerontol Geriatr. 2014; 60(1):16-21. DOI: 10.1016/j.archger.2014.10.022. View

Wiering B, de Boer D, Delnoij D . Patient involvement in the development of patient-reported outcome measures: a scoping review. Health Expect. 2016; 20(1):11-23. PMC: 5217930. DOI: 10.1111/hex.12442. View

Elwyn G, Vermunt N . Goal-Based Shared Decision-Making: Developing an Integrated Model. J Patient Exp. 2020; 7(5):688-696. PMC: 7705836. DOI: 10.1177/2374373519878604. View

Donnelly C, Carswell A . Individualized outcome measures: a review of the literature. Can J Occup Ther. 2002; 69(2):84-94. DOI: 10.1177/000841740206900204. View

van Alphen A, Westerman M, Visschedijk J, Hertogh C . [A qualitative study of Falls Efficacy Scale-International/Hips. What do we measure?]. Tijdschr Gerontol Geriatr. 2013; 44(1):3-11. DOI: 10.1007/s12439-013-0005-9. View

Naik A, Dindo L, Van Liew J, Hundt N, Vo L, Hernandez-Bigos K . Development of a Clinically Feasible Process for Identifying Individual Health Priorities. J Am Geriatr Soc. 2018; 66(10):1872-1879. PMC: 10185433. DOI: 10.1111/jgs.15437. View

Liu R, Buffart L, Kersten M, Spiering M, Brug J, van Mechelen W . Psychometric properties of two physical activity questionnaires, the AQuAA and the PASE, in cancer patients. BMC Med Res Methodol. 2011; 11:30. PMC: 3079697. DOI: 10.1186/1471-2288-11-30. View

10.

Hesbacher P, Rickels K, Weise C . Target symptoms: a promising improvement criterion in psychiatric drug research. Arch Gen Psychiatry. 1968; 18(5):595-600. DOI: 10.1001/archpsyc.1968.01740050083014. View

11.

Reuben D, Tinetti M . Goal-oriented patient care--an alternative health outcomes paradigm. N Engl J Med. 2012; 366(9):777-9. DOI: 10.1056/NEJMp1113631. View

12.

van Seben R, Reichardt L, Smorenburg S, Buurman B . Goal-Setting Instruments in Geriatric Rehabilitation: A Systematic Review. J Frailty Aging. 2017; 6(1):37-45. DOI: 10.14283/jfa.2016.103. View

13.

Stolee P, Rockwood K, Fox R, Streiner D . The use of goal attainment scaling in a geriatric care setting. J Am Geriatr Soc. 1992; 40(6):574-8. DOI: 10.1111/j.1532-5415.1992.tb02105.x. View

14.

Tinetti M, Naik A, Dodson J . Moving From Disease-Centered to Patient Goals-Directed Care for Patients With Multiple Chronic Conditions: Patient Value-Based Care. JAMA Cardiol. 2016; 1(1):9-10. PMC: 6995667. DOI: 10.1001/jamacardio.2015.0248. View

15.

Fried T, Tinetti M, Agostini J, Iannone L, Towle V . Health outcome prioritization to elicit preferences of older persons with multiple health conditions. Patient Educ Couns. 2010; 83(2):278-82. PMC: 2945432. DOI: 10.1016/j.pec.2010.04.032. View

16.

Mangin D, Stephen G, Bismah V, Risdon C . Making patient values visible in healthcare: a systematic review of tools to assess patient treatment priorities and preferences in the context of multimorbidity. BMJ Open. 2016; 6(6):e010903. PMC: 4908882. DOI: 10.1136/bmjopen-2015-010903. View

17.

BATTLE C, Imber S, Hoehn-Saric R, Nash E, Frank J . Target complaints as criteria of improvement. Am J Psychother. 1966; 20(1):184-92. DOI: 10.1176/appi.psychotherapy.1966.20.1.184. View

18.

Ribbink M, Macneil-Vroomen J, van Seben R, Oudejans I, Buurman B . Investigating the effectiveness of care delivery at an acute geriatric community hospital for older adults in the Netherlands: a protocol for a prospective controlled observational study. BMJ Open. 2020; 10(3):e033802. PMC: 7170597. DOI: 10.1136/bmjopen-2019-033802. View

19.

van der Kluit M, Dijkstra G, de Rooij S . Goals of older hospitalised patients: a qualitative descriptive study. BMJ Open. 2019; 9(8):e029993. PMC: 6687021. DOI: 10.1136/bmjopen-2019-029993. View

20.

Beaton D, Bombardier C, Guillemin F, Ferraz M . Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000; 25(24):3186-91. DOI: 10.1097/00007632-200012150-00014. View