Thestrup Hansen Stine, Kjerholt Mette, Friis Christensen Sarah, Hølge-Hazelton Bibi, Brodersen John
Department of Haematology, Zealand University Hospital, Vestermarksvej 9, 1.sal, 4000, Roskilde, Denmark.
Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
J Patient Rep Outcomes. 2019 Dec 28;3(1):74. doi: 10.1186/s41687-019-0166-6.
The patient-doctor relationship is crucial to provide person-centred care, allowing the alleviation of symptom burden caused by disease or treatment. Implementing Patient Reported Outcome Measures (PROMs) is suggested to inform the decision-making process and lead to initiation of care. Yet there are knowledge gaps regarding how meaningful it is to incorporate PROMs in clinical settings. The aim of this study was to investigate haematologists' experiences when PROMs were implemented in an outpatient setting.
Fourteen participant observations, 13 individual interviews and three in-depth interviews were conducted with haematologists, guided by the qualitative methodology Interpretive Description. Analysis was inspired by Habermas' critical theoretical framework.
The haematologists included were characterised by dichotomous experiences with PROMs, either resistant to or supporting their implementation. None were observed to elaborate on PROMs during consultations: instead, primary attention was spent discussing the hematological agenda dictated by the system.
The use of PROMs for individualized care was linked with extensive uncertainties and PROMs were not requested by the haematologists. To improve individualized care, other approaches may be more suitable. If PROMs are to be incorporated into future clinical practice, they should be tested tothe specific patient group and involve relevant users.
医患关系对于提供以患者为中心的护理至关重要，有助于减轻疾病或治疗所带来的症状负担。建议实施患者报告结局测量（PROMs）以指导决策过程并启动护理。然而，关于在临床环境中纳入PROMs的意义仍存在知识空白。本研究的目的是调查血液科医生在门诊环境中实施PROMs时的经验。
采用诠释性描述的定性方法，对血液科医生进行了14次参与观察、13次个人访谈和3次深入访谈。分析受到哈贝马斯批判理论框架的启发。
参与研究的血液科医生对PROMs有着截然不同的体验，要么抵制其实施，要么支持其实施。在会诊期间，没有观察到有人详细阐述PROMs：相反，主要精力都花在讨论系统规定的血液学议程上。
使用PROMs进行个性化护理存在诸多不确定性，血液科医生并未要求使用PROMs。为了改善个性化护理，其他方法可能更合适。如果要将PROMs纳入未来的临床实践，应该针对特定患者群体进行测试，并让相关用户参与其中。
