What counts as patient-important upper gastrointestinal bleeding in the ICU? A mixed-methods study protocol of patient and family perspectives.

Autor:	Cook DJ; Medicine, McMaster University, Hamilton, Ontario, Canada debcook@mcmaster.ca.; Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.; Critical Care, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada., Swinton M; Family Medicine, McMaster University, Hamilton, Ontario, Canada., Krewulak KD; Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada., Fiest K; Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada., Dionne J; Medicine, McMaster University, Hamilton, Ontario, Canada.; Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.; Critical Care, Hamilton Health Sciences, Hamilton, Ontario, Canada., Debigare S; Patient and Family Partnership Committee, Canadian Critical Care Trials Group, Montreal, Quebec, Canada., Guyatt G; Medicine, McMaster University, Hamilton, Ontario, Canada.; Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada., Taneja S; Family Medicine, McMaster University, Hamilton, Ontario, Canada., Alhazzani W; Medicine, McMaster University, Hamilton, Ontario, Canada.; Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.; Critical Care, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada., Burns KEA; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada., Marshall JC; Surgery and Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada., Muscedere J; Critical Care Medicine, Kingston Health Sciences Center, Queens University, Kingston, Ontario, Canada., Gouskos A; Patient and Family Advisory Committee and Steering Committee Representative, Toronto, Ontario, Canada., Finfer S; Critical Care, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.; The George Institute for Global Health, School of Public Health, Imperial College London, London, UK., Deane AM; Critical Care, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia., Myburgh J; Critical Care, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia., Rochwerg B; Medicine, McMaster University, Hamilton, Ontario, Canada.; Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.; Critical Care, Hamilton Health Sciences, Hamilton, Ontario, Canada., Ball I; Medicine and Epidemiology and Biostatistics, Western University, London, Ontario, Canada., Mele T; Surgery and Critical Care Medicine, Western University, London, Ontario, Canada., Niven D; Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada., English S; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.; Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada., Verhovsek M; Medicine, McMaster University, Hamilton, Ontario, Canada., Vanstone M; Family Medicine, McMaster University, Hamilton, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 May 19; Vol. 13 (5), pp. e070966. Date of Electronic Publication: 2023 May 19.
DOI:	10.1136/bmjopen-2022-070966
Abstrakt:	Introduction: Clinically important upper gastrointestinal bleeding is conventionally defined as bleeding accompanied by haemodynamic changes, requiring red blood cell transfusions or other invasive interventions. However, it is unclear if this clinical definition reflects patient values and preferences. This protocol describes a study to elicit views from patients and families regarding features, tests, and treatments for upper gastrointestinal bleeding that are important to them. Methods and Analysis: This is a sequential mixed-methods qualitative-dominant multi-centre study with an instrument-building aim. We developed orientation tools and educational materials in partnership with patients and family members, including a slide deck and executive summary. We will invite intensive care unit (ICU) survivors and family members of former ICU patients to participate. Following a virtual interactive presentation, participants will share their perspectives in an interview or focus group. Qualitative data will be analysed using inductive qualitative content analysis, wherein codes will be derived directly from the data rather than using preconceived categories. Concurrent data collection and analysis will occur. Quantitative data will include self-reported demographic characteristics. This study will synthesise the values and perspectives of patients and family members to create a new trial outcome for a randomised trial of stress ulcer prophylaxis. This study is planned for May 2022 to August 2023. The pilot work was completed in Spring 2021. Ethics and Dissemination: This study has ethics approval from McMaster University and the University of Calgary. Findings will be disseminated via manuscript and through incorporation as a secondary trial outcome on stress ulcer prophylaxis. Trial Registration Number: NCT05506150. Competing Interests: Competing interests: The following individuals are investigators for the randomised trial REVISE: DJC, JD, GG, WA, KEAB, JCM, JMu, SF, AMD, JMy, BR, IB, TM, DN, SE. We have no other conflicts of interest to declare. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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