title: Patient-centered outcomes on quality of life and anthroposophic healthcare: a qualitative triangulation study.
abstract: To provide a qualitative investigation of aspects that matter to patients regarding quality of life (QOL) and other perceived treatment effects of anthroposophic healthcare (AH). It is a first step in the development of patient reported outcome measures (PROMs) for AH. Hence, it will contribute to the evaluation of AH quality from patients' perspectives.
  
  
  
  Within-method triangulation of four qualitative data sources is: (1) Survey of 2063 patients of AH general practitioners; single open item; (2) Survey of 34 patients of AH nurses; single open item; (3) and (4) Sixteen semi-structured interviews with patients. The data sources contained patients' qualitative reports on contribution of treatment to QOL, other perceived treatment effects and/or quality of care aspects. Content analysis Construction of items and domains by open, axial and selective coding.
  
  
  
  Twelve domains regarding quality of life are found: Recovery/Symptom reduction, Active contribution/Autonomy, General well-being, Meaning, Rest/Relaxation, Functioning, Energy/Strength, Care relationship, Natural healing, Mindful inner attitude, Being well informed and Social relations. The interviews demonstrate relations between domains.
  
  
  
  The findings give a comprehensive insight into aspects of care that are relevant to patients, providing a first step to develop PROMs for AH. Findings show a broadening of domains compared to existing measurement instruments and show close similarities with the recently developed concept of "positive health." Extending QOL instruments with a broader set of domains would give concrete tools to improve evaluation of quality of care and make this evaluation more in line with aspects that matter to AH patients.
authors.affiliation: University of Applied Sciences Leiden, Zernikedreef 11, 2333 CK, Leiden, The Netherlands. Koster.e@hsleiden.nl.
authors.forename: Evi B
authors.identifier: 0000-0002-5205-6837
authors.initials: EB
authors.lastname: Koster
authors.affiliation: University of Applied Sciences Leiden, Zernikedreef 11, 2333 CK, Leiden, The Netherlands.
authors.forename: Erik W
authors.initials: EW
authors.lastname: Baars
authors.affiliation: Tilburg School of Social and Behavioral Sciences, Scientific Centre for Transformation in Care and Welfare (Tranzo), Tilburg University, Postbus 90153, 5000 LE, Tilburg, The Netherlands.
authors.forename: Diana M J
authors.initials: DM
authors.lastname: Delnoij
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D063868:Patient Outcome Assessment; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Anthroposophic healthcare; Patient reported outcomes measures; Patient-centered care; Qualitative triangulation; Quality of care; Quality of life