Recommendations of older adults on how to use the PROM ‘TOPICS-MDS’ in healthcare conversations: A Delphi study

Autoři: Ruth E. Pel-Littel aff001;  Cynthia S. Hofman aff001;  Liesje Yu aff003;  Silke F. Metzelthin aff004;  Franca H. Leeuwis aff005;  Jeanet W. Blom aff006;  B. M. Buurman aff002;  Mirella M. Minkman aff001
Působiště autorů: Department of Innovation and Research, Vilans, Centre of expertise for long-term care, Utrecht, the Netherlands aff001;  Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands aff002;  Faculty of Earth and Life Sciences, VU University, Amsterdam, the Netherlands aff003;  Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands aff004;  Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, the Netherlands aff005;  Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands aff006;  University of Tilburg, TIAS school for Business and Society, Tilburg, the Netherlands aff007
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225344


In shared decision making, the exploration of preferred personal health outcomes is important. Patient-reported outcome measures (PROMs) provide input for discussions between patients and healthcare professionals. The Older Persons and Informal Caregivers Survey Minimum DataSet (TOPICS-MDS) PROM is a multidimensional questionnaire on the physical and mental health and wellbeing of older adults. This study investigates how the TOPICS-MDS could be used in individual healthcare conversations. We explored views of older adults regarding 1) whether the health domains they want to discuss are included in the TOPICS-MDS and 2) the comprehensibility of the TOPICS-MDS for healthcare conversations with older adults. A three-round Delphi study was conducted. A total of 57 older adults participated in the study, the mean (SD) age was 71.5 (8.5) years, and 78.9% of the participants were female. The participants were divided into four panels based on educational level and cultural background. We used online questionnaires and focus groups. Consensus was pre-defined to be the point when ≥75% of the participants agreed that a domain was important or very important (scored on a 5-point Likert scale). The inter-expert agreement was computed for Round 1 and 3 with Kendall’s W. Round 2 was a focus-group. Qualitative data were analyzed by content analysis. Older adults considered 'functional limitations', 'emotional wellbeing', 'social functioning' and 'quality of life' to be important domains of the TOPICS-MDS to discuss in healthcare conversations. The participants added 'coping with stress', 'dealing with health conditions and the effects on life' as extra domains for healthcare conversations. Challenges regarding the comprehensibility of the TOPICS-MDS included difficult words and lengthy or sensitive questions. Questions that included multiple topics were difficult to understand. The TOPICS-MDS covers the domains of life that older adults value as important to discuss with healthcare professionals, and two additional domains were identified. For older adults with a low level of education or a culturally diverse background, the TOPICS-MDS needs to be adjusted for comprehensibility.

Klíčová slova:

Allied health care professionals – Behavioral and social aspects of health – Elderly – Emotions – Mental health and psychiatry – Netherlands – Quality of life – Questionnaires


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