Priority quality indicators for palliative care services in Portugal

Detalhes bibliográficos
Autor(a) principal: Capelas, Manuel Luís
Data de Publicação: 2018
Outros Autores: Simões, Ana Sofia Antunes Wangricken Fonseca, Teves, Carla Filomena Tavares Marinho, Durão, Sofia Amado Pinto, Coelho, Sílvia Patrícia Fernandes, da Silva, Sanda Catarina Fonseca Simões, Silva, Alexandre Ernesto, Afonso, Tânia dos Santos
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.34632/cadernosdesaude.2018.7245
Resumo: Introduction: The determination of basic and priority quality indicators for Palliative Care services in Portugal was understood as an important field of study. Quality emerges in the health landscape due to the intrinsic relationship with the response to the needs of patients and families; It is quality health care that ensures the best health coverage and, at the same time, encompasses the strategies needed to better respond to patients, families and society. In view of the above, quality indicators are understood as essential instruments in public health policies.  Aim: To develop 25 basic and priority quality indicators for Palliative Care services in Portugal. Materials and Methods: Analytical study completed in 2017, using the Delphi Method applied in 3-step consensus determination. An expert health panel with health professionals working in Palliative Care services for at least 3 years has been set for the study. Results: Indicators were first selected for consensus building; 44 quality indicators were obtained with a selection variance between 64.9% and 18.4% of the experts comprising the different typologies and domains: 12 structure, 28 process and 4 result indicators. In the developing of the selection process by consensus there was very high consensus for 17 indicators (2 structure, 14 process and 1 outcome), high consensus for 21 indicators (7 structure, 12 process and 2 outcome), moderate consensus on 5 indicators (3 structure and 2 process) and low consensus on 1 (outcome) indicator. Conclusion: The study identified 25 high or very high consensus quality indicators, fulfilling its objective. The final list of priority indicators includes all indicators with very high consensus, and high consensus indicators were ranked by proportion of agreement, that is, the proportion of experts who agree or very agree on the indicator's priority factor. Considering all the domains under study, they are globally represented in the final sample, except for the domain of spiritual, religious and existential aspects of care. In this way, a set of 25 indicators were defined: 4 structure indicators, 20 process indicators and 1 outcome indicator. The set of indicators allows an objective and systematized analysis of care, contributing to the best culture evaluation, from which better care response, effectiveness and efficiency will be achieved. 
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spelling Priority quality indicators for palliative care services in PortugalIndicadores de qualidade prioritários para os serviços de cuidados paliativos em PortugalIntroduction: The determination of basic and priority quality indicators for Palliative Care services in Portugal was understood as an important field of study. Quality emerges in the health landscape due to the intrinsic relationship with the response to the needs of patients and families; It is quality health care that ensures the best health coverage and, at the same time, encompasses the strategies needed to better respond to patients, families and society. In view of the above, quality indicators are understood as essential instruments in public health policies.  Aim: To develop 25 basic and priority quality indicators for Palliative Care services in Portugal. Materials and Methods: Analytical study completed in 2017, using the Delphi Method applied in 3-step consensus determination. An expert health panel with health professionals working in Palliative Care services for at least 3 years has been set for the study. Results: Indicators were first selected for consensus building; 44 quality indicators were obtained with a selection variance between 64.9% and 18.4% of the experts comprising the different typologies and domains: 12 structure, 28 process and 4 result indicators. In the developing of the selection process by consensus there was very high consensus for 17 indicators (2 structure, 14 process and 1 outcome), high consensus for 21 indicators (7 structure, 12 process and 2 outcome), moderate consensus on 5 indicators (3 structure and 2 process) and low consensus on 1 (outcome) indicator. Conclusion: The study identified 25 high or very high consensus quality indicators, fulfilling its objective. The final list of priority indicators includes all indicators with very high consensus, and high consensus indicators were ranked by proportion of agreement, that is, the proportion of experts who agree or very agree on the indicator's priority factor. Considering all the domains under study, they are globally represented in the final sample, except for the domain of spiritual, religious and existential aspects of care. In this way, a set of 25 indicators were defined: 4 structure indicators, 20 process indicators and 1 outcome indicator. The set of indicators allows an objective and systematized analysis of care, contributing to the best culture evaluation, from which better care response, effectiveness and efficiency will be achieved. Introdução: A determinação de indicadores de qualidade básicos e prioritários para os serviços de Cuidados Paliativos em Portugal entendeu-se como um importante campo de estudo. A qualidade insurge-se no panorama da Saúde pela intrínseca relação com a resposta às necessidades de doentes e famílias; são os cuidados de saúde de qualidade aqueles que garantem a melhor cobertura em saúde e, simultaneamente, que englobam as estratégias necessárias à melhor resposta a doentes, famílias e sociedade. Atendendo ao tema mencionado, entendem-se os indicadores de qualidade como instrumentos essenciais nas políticas de saúde pública e como garante da qualidade das mesmas. Objetivo: Desenvolver 25 indicadores de qualidade básicos e prioritários para os serviços de Cuidados Paliativos em Portugal. Materiais e Métodos: Estudo analítico que decorreu em 2017, com recurso ao Método Delphi aplicado em determinação de consenso em 3 etapas. Definido para o estudo um painel de peritos de profissionais de saúde a exercerem em serviços de Cuidados Paliativos há pelo menos 3 anos. Resultados: Os indicadores foram primeiramente selecionados para a formação de consensos; obtiveram-se 44 indicadores de qualidade com uma variância de seleção entre 64.9% e 18.4% dos peritos compreendendo as diferentes tipologias e domínios: 12 de estrutura, 28 indicadores de processo e 4 de resultado. No desenvolvimento do processo de seleção por consenso verificou-se um consenso muito elevado para 17 indicadores (2 de estrutura, 14 de processo e 1 de resultado), consenso elevado para 21 indicadores (7 de estrutura, 12 de processo e 2 de resultado), consenso moderado em 5 indicadores (3 de estrutura e 2 de processo) e baixo consenso em 1 indicador (de resultado). Conclusões: O estudo identificou 25 indicadores de qualidade de consenso elevado ou muito elevado, cumprindo o seu objetivo. Da lista final de indicadores prioritários fazem parte todos os indicadores com consenso muito elevado, tendo sido seriados os indicadores de consenso elevado por proporção de concordância, entenda-se, a proporção de peritos em concordância ou muita concordância quanto ao fator prioritário do indicador. Considerando todos os domínios em estudo, os mesmos estão globalmente representados na amostra final, à exceção do domínio dos aspetos espirituais, religiosos e existenciais do cuidar. Definiu-se, deste modo, um conjunto de 25 indicadores dos quais fazem parte: 4 indicadores de estrutura, 20 indicadores de processo e 1 de resultado. O conjunto de indicadores permite uma análise objetiva e sistematizada dos cuidados, em contributo para a melhor cultura de avaliação, a partir da qual se conseguirá melhor resposta assistencial, efetividade e eficiência. Universidade Católica Portuguesa2018-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.34632/cadernosdesaude.2018.7245https://doi.org/10.34632/cadernosdesaude.2018.7245Cadernos de Saúde; Vol 10 No 2 (2018); 11-24Cadernos de Saúde; v. 10 n. 2 (2018); 11-242795-43581647-055910.34632/cadernosdesaude.2018.10.2reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revistas.ucp.pt/index.php/cadernosdesaude/article/view/7245https://revistas.ucp.pt/index.php/cadernosdesaude/article/view/7245/9372Direitos de Autor (c) 2020 Manuel Luís Capelas, Ana Sofia Antunes Wangricken Fonseca Simões, Carla Filomena Tavares Marinho Teves, Sofia Amado Pinto Durão, Sílvia Patrícia Fernandes Coelho, Sanda Catarina Fonseca Simões da Silva, Alexandre Ernesto Silva, Tânia dos Santos Afonsohttp://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessCapelas, Manuel LuísSimões, Ana Sofia Antunes Wangricken FonsecaTeves, Carla Filomena Tavares MarinhoDurão, Sofia Amado PintoCoelho, Sílvia Patrícia Fernandesda Silva, Sanda Catarina Fonseca SimõesSilva, Alexandre ErnestoAfonso, Tânia dos Santos2023-10-03T15:47:57Zoai:ojs.revistas.ucp.pt:article/7245Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:33:09.018292Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Priority quality indicators for palliative care services in Portugal
Indicadores de qualidade prioritários para os serviços de cuidados paliativos em Portugal
title Priority quality indicators for palliative care services in Portugal
spellingShingle Priority quality indicators for palliative care services in Portugal
Capelas, Manuel Luís
title_short Priority quality indicators for palliative care services in Portugal
title_full Priority quality indicators for palliative care services in Portugal
title_fullStr Priority quality indicators for palliative care services in Portugal
title_full_unstemmed Priority quality indicators for palliative care services in Portugal
title_sort Priority quality indicators for palliative care services in Portugal
author Capelas, Manuel Luís
author_facet Capelas, Manuel Luís
Simões, Ana Sofia Antunes Wangricken Fonseca
Teves, Carla Filomena Tavares Marinho
Durão, Sofia Amado Pinto
Coelho, Sílvia Patrícia Fernandes
da Silva, Sanda Catarina Fonseca Simões
Silva, Alexandre Ernesto
Afonso, Tânia dos Santos
author_role author
author2 Simões, Ana Sofia Antunes Wangricken Fonseca
Teves, Carla Filomena Tavares Marinho
Durão, Sofia Amado Pinto
Coelho, Sílvia Patrícia Fernandes
da Silva, Sanda Catarina Fonseca Simões
Silva, Alexandre Ernesto
Afonso, Tânia dos Santos
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Capelas, Manuel Luís
Simões, Ana Sofia Antunes Wangricken Fonseca
Teves, Carla Filomena Tavares Marinho
Durão, Sofia Amado Pinto
Coelho, Sílvia Patrícia Fernandes
da Silva, Sanda Catarina Fonseca Simões
Silva, Alexandre Ernesto
Afonso, Tânia dos Santos
description Introduction: The determination of basic and priority quality indicators for Palliative Care services in Portugal was understood as an important field of study. Quality emerges in the health landscape due to the intrinsic relationship with the response to the needs of patients and families; It is quality health care that ensures the best health coverage and, at the same time, encompasses the strategies needed to better respond to patients, families and society. In view of the above, quality indicators are understood as essential instruments in public health policies.  Aim: To develop 25 basic and priority quality indicators for Palliative Care services in Portugal. Materials and Methods: Analytical study completed in 2017, using the Delphi Method applied in 3-step consensus determination. An expert health panel with health professionals working in Palliative Care services for at least 3 years has been set for the study. Results: Indicators were first selected for consensus building; 44 quality indicators were obtained with a selection variance between 64.9% and 18.4% of the experts comprising the different typologies and domains: 12 structure, 28 process and 4 result indicators. In the developing of the selection process by consensus there was very high consensus for 17 indicators (2 structure, 14 process and 1 outcome), high consensus for 21 indicators (7 structure, 12 process and 2 outcome), moderate consensus on 5 indicators (3 structure and 2 process) and low consensus on 1 (outcome) indicator. Conclusion: The study identified 25 high or very high consensus quality indicators, fulfilling its objective. The final list of priority indicators includes all indicators with very high consensus, and high consensus indicators were ranked by proportion of agreement, that is, the proportion of experts who agree or very agree on the indicator's priority factor. Considering all the domains under study, they are globally represented in the final sample, except for the domain of spiritual, religious and existential aspects of care. In this way, a set of 25 indicators were defined: 4 structure indicators, 20 process indicators and 1 outcome indicator. The set of indicators allows an objective and systematized analysis of care, contributing to the best culture evaluation, from which better care response, effectiveness and efficiency will be achieved. 
publishDate 2018
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dc.publisher.none.fl_str_mv Universidade Católica Portuguesa
publisher.none.fl_str_mv Universidade Católica Portuguesa
dc.source.none.fl_str_mv Cadernos de Saúde; Vol 10 No 2 (2018); 11-24
Cadernos de Saúde; v. 10 n. 2 (2018); 11-24
2795-4358
1647-0559
10.34632/cadernosdesaude.2018.10.2
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