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在为结直肠癌患者提供护士主导的支持性护理中使用患者报告结局量表(PROMs)的可行性和可接受性。

Feasibility and acceptability of the use of patient-reported outcome measures (PROMs) in the delivery of nurse-led supportive care to people with colorectal cancer.

作者信息

Kotronoulas Grigorios, Papadopoulou Constantina, MacNicol Lorna, Simpson Mhairi, Maguire Roma

机构信息

Department of Computer and Information Sciences, University of Strathclyde, Glasgow, UK.

School of Health, Nursing and Midwifery, University of the West of Scotland, Paisley, UK.

出版信息

Eur J Oncol Nurs. 2017 Aug;29:115-124. doi: 10.1016/j.ejon.2017.06.002. Epub 2017 Jun 15.

Abstract

PURPOSE

Logistical issues pertinent to the use of patient-reported outcome measures (PROMs) by colorectal cancer nurse specialists (CNS) to identify the needs of people with colorectal cancer (CRC) in acute care remain unknown. We explored the feasibility and acceptability of PROMs-driven, CNS-led consultations to enhance delivery of supportive care to people with CRC completing adjuvant chemotherapy.

METHODS

A systematic literature review and focus groups with patients and CNS (Phase 1) were followed by a repeated-measures, exploratory study (Phase 2), whereby pre-consultation PROM data were collected during three consecutive, monthly consultations, and used by the CNS to enable delivery of personalised supportive care.

RESULTS

Based on Phase 1 data, the Supportive Care Needs Survey was selected for use in Phase 2. Fourteen patients were recruited (recruitment rate: 56%); thirteen (93%) completed all study assessments. Forty in-clinic patient-clinician consultations took place. At baseline, 219 unmet needs were reported in total, with a notable 21% (T2) and 32% (T3) over-time reduction. Physical/daily living and psychological domain scores declined from T1 to T3, yet not statistically significantly. In exit interviews, patients described how using the PROM helped them shortlist and prioritise their needs. CNS stressed how the PROM helped them tease out more issues with patients than they would normally.

CONCLUSIONS

Nurse-led, PROMs-driven needs assessments with patients with CRC appear to be feasible and acceptable in clinical practice, possibly associated with a sizeable reduction in the frequency of unmet needs, and smaller decreases in physical/daily living and psychosocial needs in the immediate post-chemotherapy period.

摘要

目的

结直肠癌护理专家(CNS)使用患者报告结局量表(PROMs)来确定急性护理中结直肠癌(CRC)患者需求的相关后勤问题仍不明确。我们探讨了以PROMs为驱动、由CNS主导的咨询,以加强对完成辅助化疗的CRC患者提供支持性护理的可行性和可接受性。

方法

在进行系统文献综述以及与患者和CNS开展焦点小组讨论(第1阶段)之后,进行了一项重复测量的探索性研究(第2阶段),即在连续三个月的每月一次咨询中收集咨询前的PROM数据,并由CNS用于提供个性化的支持性护理。

结果

根据第1阶段的数据,选择了支持性护理需求调查用于第2阶段。招募了14名患者(招募率:56%);13名(93%)完成了所有研究评估。共进行了40次门诊患者与临床医生的咨询。基线时,总共报告了219项未满足的需求,随着时间推移显著减少了21%(T2)和32%(T3)。身体/日常生活和心理领域得分从T1到T3有所下降,但无统计学意义。在出院访谈中,患者描述了使用PROM如何帮助他们筛选需求并确定需求的优先级。CNS强调PROM如何帮助他们比平时更深入地了解患者的更多问题。

结论

由护士主导、以PROMs为驱动的CRC患者需求评估在临床实践中似乎是可行且可接受的,可能与未满足需求的频率大幅降低以及化疗后短期内身体/日常生活和心理社会需求的较小降幅有关。

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