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护士在门诊引入患者报告结局测量工具时的体验:一项阐释性描述研究。

Nurses' Experiences When Introducing Patient-Reported Outcome Measures in an Outpatient Clinic: An Interpretive Description Study.

机构信息

Author Affiliations: Department of Haematology, Zealand University Hospital, Roskilde (Mrs Hansen and Drs Kjerholt and Christensen); Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense (Mrs Hansen and Hølge-Hazelton); Faculty of Health and Medical Sciences (Dr Christensen) and Department of General Practice, Institute of Public Health, Faculty of Health Sciences (Dr Brodersen), University of Copenhagen; and The Research Support Unit at Zealand University Hospital, Roskilde (Mrs Hølge-Hazelton), Denmark.

出版信息

Cancer Nurs. 2021;44(2):E108-E120. doi: 10.1097/NCC.0000000000000808.

Abstract

BACKGROUND

Application of patient-reported outcome measures (PROM) seems to be a step toward person-centered care and identifying patients' unmet needs.

OBJECTIVE

To investigate the experiences of nurses when PROMs were introduced in a hematological clinical practice as part of a multimethod intervention study.

METHODS

The qualitative framework was guided by the interpretive description (ID) methodology, including a focused ethnographic approach with participant observations and interviews. The instruments introduced were the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the Outcomes and Experiences Questionnaire. Analysis was inspired by Habermas' critical theory.

RESULTS

The analysis revealed 2 predominant themes of nurses' experiences: "PROMs are only used when there is time-which there rarely is" and "PROMs cannot be used without a strategy, just because they are present."

CONCLUSIONS

Nurses' experiences with PROMs depended on the systems' rationale, resulting in limited capacity to use and explore PROMs. Nurses believed that PROMs might have the potential to support clinical practice, as PROMs added new information about patients' conditions but also identified needs within supportive care, leaving the potential of PROMs uncertain. Simply introducing PROMs to practice does not necessarily actuate their potential because use of PROMs is dependent on institutional conditions and mandatory tasks are prioritized.

IMPLICATIONS FOR PRACTICE

This study contributes knowledge of nurses' experiences when introducing PROMs in a hematological outpatient clinical practice. Findings can guide future PROMs research within the field of nursing.

摘要

背景

应用患者报告结局测量(PROM)似乎是迈向以患者为中心的护理和识别患者未满足需求的一步。

目的

调查护士在血液学临床实践中引入 PROM 作为多方法干预研究的一部分时的体验。

方法

定性框架由解释性描述(ID)方法指导,包括参与观察和访谈的聚焦民族志方法。引入的工具是欧洲癌症研究和治疗组织的生活质量问卷核心 30 项和结果与体验问卷。分析受到哈贝马斯批判理论的启发。

结果

分析揭示了护士体验的 2 个主要主题:“只有有时间时才会使用 PROM-但很少有时间”和“没有策略就不能使用 PROM,即使它们存在”。

结论

护士对 PROM 的体验取决于系统的基本原理,导致使用和探索 PROM 的能力有限。护士认为 PROM 有可能支持临床实践,因为 PROM 提供了患者病情的新信息,但也确定了支持性护理中的需求,使 PROM 的潜在作用不确定。仅仅将 PROM 引入实践并不一定能发挥其潜力,因为 PROM 的使用取决于机构条件,并且强制性任务被优先考虑。

实践意义

本研究为护士在血液学门诊临床实践中引入 PROM 时的体验提供了知识。研究结果可以为护理领域的未来 PROM 研究提供指导。

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