Developing outcome measures assessing wound management and patient experience: a mixed methods study

Daisy Elliott, Lazaros Andronis, Jane Blazeby, Natalie Blencowe, Melanie Calvert, Joanna Coast, Timothy Draycott, Jenny Donovan, Rachael Gooberman-Hill, Robert Longman, Laura Magill, Jonathan Mathers, Thomas Pinkney, Barnaby Reeves, Chris Rogers, Leila Rooshenas, Andrew Torrance, Nicky Welton, Mark Woodward, Trudie YoungJo C. Dumville, Louise Flintoff, Rhiannon Macefield, David Messenger, Christel McMullan, Charlotte Murkin, Helen Van Der Nelson, The Bluebelle Study Group

Research output: Contribution to journalArticle (Academic Journal)peer-review

7 Citations (Scopus)
352 Downloads (Pure)

Abstract

Objectives: To develop outcome measures to assess practical management of primary surgical wounds and patient experience.

Design: Mixed methods, including qualitative interviews and data extraction from published RCTs.

Setting: Two university-teaching NHS hospitals and three district NHS hospitals in the South West and Midlands regions of England.

Participants: Sixty-four patients and 15 health care professionals from abdominal general surgical specialities and obstetrics (caesarean section).

Methods: Measures were developed according to standard guidelines to identify issues relevant to patients’ experiences of surgical wounds and dressings, including analysis of existing RCT outcomes and interviews. These were written into provisional questionnaire items for a single outcome measure. Cognitive interviews with patients and health care professionals assessed face validity, acceptability and relevance. Findings from interviews were regularly shared with the study team who suggested amendments to modify and reword items to improve understanding before further iterative testing with patients and health care professionals.

Results: Analyses of existing RCT outcomes and interviews produced a total of 69 issues. Pre-testing and iterative revision established the need for two separate measures. One measure addresses health care professionals’ experience of wound management in two key areas: exudate and its impact, and allergic reactions to the dressing. The other measure addresses patients’ experience of wounds in seven key areas: wound comfort, dressing removal, dressings to protect the wound, impact on daily activities, ease of movement, anxiety about the wound and satisfaction with dressing. Each measure took less than five minutes to complete and were understood and acceptable to patients and health care professionals.

Conclusion: This in-depth study has developed two measures to assess practical management of primary surgical wounds and patient experience. Further work to test their validity and reliability and application to other settings is now required.
Original languageEnglish
Article numbere016155
Number of pages8
JournalBMJ Open
Volume7
Issue number11
Early online date26 Nov 2017
DOIs
Publication statusPublished - Nov 2017

Structured keywords

  • BTC (Bristol Trials Centre)
  • Centre for Surgical Research

Keywords

  • Qualitative research
  • wounds
  • dressings
  • outcome measures
  • instrument development
  • patient-reported outcomes
  • questionnaire development
  • patient experience

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