چکیده (انگلیسی):

Background:Primary care clinicians often address multiple patient problems, with a range of possible outcomes.
There is currently no patient-reported outcome measure (PROM) which covers this range of outcomes. Consequently,
many researchers use PROMs that do not capture the full impact of primary care services. In order to identify what
outcomes a PROM for primary care would need to include, we conducted interviews with patients and
practitioners. This paper reports these patient and practitioners’ views on the outcomes arising from primary
care consultations.
Methods:Semi-structured interviews were held with 30 patients and eight clinicians across five sites in Bristol.
Interviews were audio-recorded, transcribed and analysed thematically. We used a broad definition of health
outcome as‘the impacts of healthcare on health, or a patient’s ability to impact health’ to identify outcomes
through this process.
Results:10outcomegroupswereidentified.Theseoccupied3domains:
Health Empowerment: These are the internal and external resources which enable patients to improve their
health. This involves 1) patients’ understanding of their illnesses, 2) ability to self-care and stay healthy, 3) agreeing and
adhering to a patient-clinician shared plan, 4) confidence in seeking healthcare and 5) access to support.
Health Status: This involves 6) reduction of symptoms and 7) reducing the impact of symptoms on patients’ lives.
Health Perceptions: This involves 8) patients’ satisfaction with their health, 9) health concerns, and 10) confidence in
their future health.
The structure, organisation and nature of primary care means it can affect all 3 domains.
Conclusions:No existing PROM captures all these outcomes. For example, manyhealth empowermentPROMs do
not consider patient preference on empowerment. Manyhealth statustools are not responsive to changes
resulting from primary care. Health perceptionsPROMs have generally been designed for measuring personality
traits rather than outcomes.
This study provides a platform for designing a new PROM containing outcomes that matter to patients and can
be influenced by primary care. Such a PROM would greatly enhance the value of primary care research