Efficiency of the elderly physical recreation programme aimed at improving functional efficiency and quality of life

Background. The study aimed to evaluate the effectiveness of the Physical Recreation Programme for the Elderly designed by Ewa Kozdroń intended to improve the functional efficiency and quality of life of women over 60 who participated in the programme. Material and methods. The research involved 73 females aged 60-74 who participated in the Physical Recreation Programme for the Elderly. The research used the author’s questionnaire, i.e. EQ-5D questionnaire and Functional Fitness Tests (FFT). Results. The results of our research confirmed a positive relationship between participation in a regular physical activity, the declared level of functional fitness and the perceived quality of life. Conclusions. A positive relationship was found in the study group between participation in regular physical activity, the declared level of functional fitness and the perceived quality of life.Wprowadzenie. Za cel badań postawiono próbę oceny efektywności Programu Rekreacji Ruchowej Osób Starszych (autorstwa Ewy Kozdroń) w zakresie sprawności funkcjonalnej i jakości życia kobiet po 60. roku życia, biorących udział w programie. Materiał i metody. Badaniami objęto 73 kobiety w wieku 60-74 lata, biorące udział w Programie Rekreacji Ruchowej Osób Starszych. W badaniach wykorzystano autorski kwestionariusz ankiety, kwestionariusz EQ-5D oraz próby sprawnościowe FFFT. Wyniki. Wyniki badań otwierdziły dodatnią zależność pomiędzy uczestnictwem w regularnej aktywności fizycznej, deklarowanym poziomem sprawności funkcjonalnej, a odczuwaną jakością życia Wnioski. W badanej grupie stwierdzono dodatnią zależność pomiędzy uczestnictwem w regularnej aktywności fizycznej, deklarowanym poziomem sprawności funkcjonalnej, a odczuwaną jakością życia

Guideline-based quality assurance: a conceptual framework for the definition of key elements

Background: In 2017, the European Commission’s Joint Research Centre (JRC) started developing a methodological framework for a guideline-based quality assurance (QA) scheme to improve cancer quality of care. During the first phase of the work, inconsistency emerged about the use of terminology for the definition, the conceptual underpinnings and the way QA relates to health questions that are answered in guidelines. The objective of this final of three articles is to propose a conceptual framework for an integrated approach to guideline and QA development and clarify terms and definitions for key elements. This work will inform the upcoming European Commission Initiative on Colorectal Cancer (ECICC). Methods: A multidisciplinary group of 23 experts from key organizations in the fields of guideline development, performance measurement and quality assurance participated in a mixed method approach including face-to-face dialogue and several rounds of virtual meetings. Informed by results of a systematic literature review that indicated absence of an existing framework and practical examples, we first identified the relations of key elements in guideline-based QA and then developed appropriate concepts and terminology to provide guidance. Results: Our framework connects the three key concepts of quality indicators, performance measures and performance indicators integrated with guideline development. Quality indicators are constructs used as a guide to monitor, evaluate, and improve the quality of the structure, process and outcomes of healthcare services; performance measures are tools that quantify or describe measurable elements of practice performance; and performance indicators are quantifiable and measurable units or scores of practice, which should be guided by guideline recommendations. Conclusions: The inconsistency in the way key terms of QA are used and defined has confused the field. Our conceptual framework defines the role, meaning and interactions of the key elements for improving quality in healthcare. It directly builds on the questions asked in guidelines and answered through recommendations. These findings will be applied in the forthcoming ECICC and for the future updates of ECIBC. These are large-scale integrated projects aimed at improving healthcare quality across Europe through the development of guideline-based QA schemes; this will help in implementing and improving our approach

Bringing two worlds closer together: a critical analysis of an integrated approach to guideline development and quality assurance schemes

Background: Although quality indicators are frequently derived from guidelines, there is a substantial gap in collaboration between the corresponding parties. To optimise workflow, guideline recommendations and quality assurance should be aligned methodologically and practically. Learning from the European Commission Initiative on Breast Cancer (ECIBC), our objective was to bring the key knowledge and most important considerations from both worlds together to inform European Commission future initiatives. Methods: We undertook several steps to address the problem. First, we conducted a feasibility study that included a survey, interviews and a review of manuals for an integrated guideline and quality assurance (QA) scheme that would support the European Commission. The feasibility study drew from an assessment of the ECIBC experience that followed commonly applied strategies leading to separation of the guideline and QA development processes. Secondly, we used results of a systematic review to inform our understanding of methodologies for integrating guideline and QA development. We then, in a third step, used the findings to prepare an evidence brief and identify key aspects of a methodological framework for integrating guidelines QA through meetings with key informants. Results: Seven key themes emerged to be taken into account for integrating guidelines and QA schemes: (1) evidence-based integrated guideline and QA frameworks are possible, (2) transparency is key in clearly documenting the source and rationale for quality indicators, (3) intellectual and financial interests should be declared and managed appropriately, (4) selection processes and criteria for quality indicators need further refinement, (5) clear guidance on retirement of quality indicators should be included, (6) risks of an integrated guideline and QA Group can be mitigated, and (7) an extension of the GIN-McMaster Guideline Development Checklist should incorporate QA considerations. Discussion: We concluded that the work of guideline and QA developers can be integrated under a common methodological framework and we provided key findings and recommendations. These two worlds, that are fundamental to improving health, can both benefit from integration