King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, London, UK.
Palliat Med. 2012 Apr;26(3):242-9. doi: 10.1177/0269216311409614. Epub 2011 Jun 22.
To examine and compare doctors' and nurses' views and experiences regarding outcome measurement in palliative care, including patient-reported outcome measures (PROMs).
A web-based survey developed through expert review and piloting was conducted in Europe and Africa with palliative care professionals working in clinical care, audit and research.
The overall participation rate was 42% (663/1592) and the overall completion rate was 59% (392/663). Of these respondents, 196 were doctors (51% male, mean 47 years) and 104 were nurses (84% female, mean 45 years). Doctors' most common reported reasons for not using tools were time constraints followed by lack of training. For nurses, it was lack of training followed by time constraints. Provision of information and guidance influenced willingness to use measures. For those that used tools, most reported favourable outcome measurement experiences. Both prioritized brief PROMs, and measures that included physical and psychological domains. For clinical purposes, the main advantage for doctors was assessment/screening, and clinical decision making for nurses. For research, doctors were most influenced by a measure's comparability with national/international literature followed by its validation in palliative care. For nurses, validation in palliative care was followed by tool access.
Overall these respondents shared similar views and experiences, and both were influenced by similar factors. Multidisciplinary outcome measurement education and training is feasible and required. Multidimensional and brief PROMs that include physical and psychological domains need to be prioritized, and access to freely available, validated and translated tools is needed to ensure cross-national comparisons and coordination of international research.
考察和比较医生和护士在姑息治疗中（包括患者报告结局测量[PROM]）对结局测量的看法和经验。
通过专家审查和试点，在欧洲和非洲开展了一项基于网络的调查，调查对象为从事临床护理、审计和研究的姑息治疗专业人员。
总体参与率为 42%（663/1592），总体完成率为 59%（392/663）。在这些受访者中，196 人是医生（51%为男性，平均年龄 47 岁），104 人是护士（84%为女性，平均年龄 45 岁）。医生不使用工具的最常见原因是时间限制，其次是缺乏培训。对于护士来说，缺乏培训是不使用工具的首要原因，其次是时间限制。提供信息和指导会影响使用工具的意愿。对于那些使用工具的人来说，大多数人报告说有良好的结局测量经验。他们都优先考虑简短的 PROM，并优先考虑包含身体和心理领域的测量工具。对于临床目的，医生的主要优势在于评估/筛选，护士的主要优势在于临床决策。对于研究，医生最看重的是衡量标准与国家/国际文献的可比性，其次是在姑息治疗中的验证。对于护士来说，在姑息治疗中的验证是其次的，而工具的可获得性则是首要考虑的。
总体而言，这些受访者有相似的观点和经验，并且受到相似因素的影响。多学科结局测量教育和培训是可行的，也是必需的。需要优先考虑多维和简短的 PROM，包括身体和心理领域，并且需要提供免费获得、验证和翻译的工具，以确保跨国比较和协调国际研究。
