Schick-Makaroff Kara, Molzahn Anita E
Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
BMC Health Serv Res. 2017 Jun 26;17(1):439. doi: 10.1186/s12913-017-2377-y.
Internationally, the use of patient-reported outcomes (PROs) is increasing. Electronic PROs (ePROs) offer immediate access of such reports to healthcare providers. The objectives of this study were to assess nurses' perspectives on the usefulness and impact of ePRO administration in home dialysis clinics and assess patient perceptions of satisfaction with nursing care following use of ePROs.
A concurrent, longitudinal, mixed methods study was conducted over 6 months during home dialysis outpatient clinic visits in two cities. Patients (n = 99) provided ePROs using tablet computers when they visited the clinic on two consecutive occasions approximately 3 months apart. Results were scored, printed, and given to nurses before patient appointments. Patients completed satisfaction items from the Comox Valley Nursing Centre Client questionnaire following their appointments. All clinic nurses (n = 11) participated and they were each interviewed twice, three months and six months after the start of the study.
The five themes that emerged from the interviews with the nurses include: enhancing focus of the nurses, directing interdisciplinary follow-up, offering support to patients through the process, interpreting results from the visual display, and integrating into workflow. Scores on the Client Questionnaire suggested that patients believed that they received excellent care (97%), and that the nurses perfectly understood their needs (90.9%). However, their satisfaction with care did not change over time when ePRO data was repeatedly provided to their nurses.
Nurses reported that sharing ePRO data in real-time informed their practice. Although there was no statistically significant change in patient satisfaction scores over time, some patients reported changes and benefits from the use of ePROs. Further research is needed to provide guidance about how ePRO data could enhance person-centered care.
在国际上，患者报告结局（PROs）的使用正在增加。电子PROs（ePROs）使医疗保健提供者能够立即获取此类报告。本研究的目的是评估护士对家庭透析诊所中ePRO管理的有用性和影响的看法，并评估患者在使用ePROs后对护理的满意度。
在两个城市的家庭透析门诊就诊期间，进行了一项为期6个月的同期纵向混合方法研究。患者（n = 99）在相隔约3个月的连续两次就诊时使用平板电脑提供ePROs。结果被评分、打印，并在患者预约前交给护士。患者在预约后完成了来自科莫克斯谷护理中心客户问卷的满意度项目。所有诊所护士（n = 11）都参与了，并且在研究开始后的3个月和6个月分别接受了两次访谈。
与护士访谈中出现的五个主题包括：增强护士的关注重点、指导跨学科随访、在此过程中为患者提供支持、解读视觉显示的结果以及融入工作流程。客户问卷的得分表明，患者认为他们得到了优质护理（97%），并且护士完全理解他们的需求（90.9%）。然而，当向护士反复提供ePRO数据时，他们对护理的满意度并未随时间而改变。
护士报告称，实时共享ePRO数据为他们的实践提供了信息。尽管患者满意度得分随时间没有统计学上的显著变化，但一些患者报告了使用ePROs带来的变化和益处。需要进一步研究以提供关于ePRO数据如何增强以患者为中心的护理的指导。
