Posthuma, S. (Selina) (2014) De efficiëntie van de digitale auto anamnese en de ervaring met deze vragenlijst op de polikliniek urogynaecologie. thesis, Medicine.
![[img]](https://umcg.studenttheses.ub.rug.nl/style/images/fileicons/text.png) |
Text
PosthumaS.pdf Restricted to Registered users only Download (8MB) |
Abstract
Introduction. The ‘digitale auto anamnese (DAA)’ is being used for several years at the outpatient clinic for urogynaecology at the Martini Hospital Groningen (The Netherlands) to evaluate patients with complaints of pelvic floor dysfunction. This questionnaire is a collection of several shorter validated questionnaires like the ‘urogenital distress inventory’, the ‘defecatory distress inventory’, the ‘incontinence impact questionnaire’ and the RAND 36, a widely used quality of life questionnaire. Before the introduction of this digital version, an analogue questionnaire was used. Current research regarding urogynaecology questionnaires has focused particularly on the predictive value of these questionnaires and on epidemiological issues concerning urogynecological diseases. Less is known about the benefits or disadvantages of a questionnaire. For example whether the DAA increases the efficiency of a consultation and in which way it contributes to the anamnesis. The overall experience and satisfaction of patients and hospital staff regarding the DAA hasn’t been studied either. Aim. To examine the efficiency of the DAA and the experience of the patients and staff with this questionnaire. To assess its contribution to a complete and well formulated medical history. Method. In a period of three months all patients with a referral for pelvic floor dysfunction were randomized for receiving the digital questionnaire (DAA+) or not (DAA-). The efficiency of the consultation was defined as the time needed for the different parts of the appointment and the number of appointments after the first contact regarding the same complaint. To examine the totality of the medical history we scored if the staff member mentioned complaints regarding the domains of prolapse (POP), urine incontinence (UI), micturition, defecation, overactive bladder (OAB) and sexuality. Patient experience was examined by a telephone survey and the experience of staff was explored by an interview at the end of the research period. Results. A total of 128 patients were randomized, 64 DAA+ and 64 DAA-. The medical history is significantly shorter (MD (Mean difference) 01m32s, 95% CI (Confidence interval) 0:00:23 – 0:02:41, p=0.009) and the time used for explanation of the condition and treatment is significantly longer (MD -01m21s, 95% CI -0:02:37 – -0:00:06, p=0.035) in the DAA+ group. We found no differences between the time of the complete appointment and the number of extra visits of both groups. After correction for the confounder staff member, the medical history is only significant shorter for gynaecologist 2 (MD 02m40s, 95% CI 0:00:58 – 0:04:23, p=0.003) in the DAA+ group. The time needed for explanation is no longer significantly different after correction for the confounder operation. The totality of the medical history is significantly less in the DAA- group regarding scores on the domains defecation (p=0.010), overactive bladder (p=0.010) and sexuality (p=0.000). The overall experience of participating patients of both research groups regarding the appointment is positive. However 29% of the patients experienced no additional value of the DAA and 20% questions its value. Twenty-nine percent of the patients who completed the DAA find that it contains unnecessary questions, such as questions that do not apply to the patient. Conclusion. The DAA increases the efficiency of a consultation and contributes to a complete medical history. Staff members are positive regarding the DAA, however attention to improve patient satisfaction is needed. To improve this the DAA has to be integrated in such way that patients believe it’s an important contribution to their care.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Ploeg, Dhr. J.M. van der and Ham, Dr. D.P. van der and Martini Ziekenhuis te Groningen. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:59 |
| Last Modified: | 25 Jun 2020 10:59 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1988 |
Actions (login required)
 |
View Item |