Institute for Occupational Medicine, Social Medicine and Health Services Research, University Hospital Tuebingen, Wilhelmstraße 27, D-72074, Tuebingen, Germany.
Clinic for Palliative Care, Faculty of Medicine, Medical Centre University of Freiburg, University of Freiburg, Freiburg, Germany.
BMC Palliat Care. 2020 Apr 4;19(1):45. doi: 10.1186/s12904-020-00554-9.
Patients in oncological and palliative care (PC) often have complex needs, which require a comprehensive treatment approach. The assessment of patient-reported outcomes (PROs) has been shown to improve identification of patient needs and foster adjustment of treatment. This study explores occupational routines, attitudes and expectations of physicians and nurses with regards to a planned electronic assessment system of PROs.
Ten physicians and nine nurses from various PC settings in Southern Germany were interviewed. The interviews were analysed with qualitative content analysis.
The interviewees were sceptical about the quality of data generated through a patient self-assessment system. They criticised the rigidity of the electronic assessment questionnaire, which the interviewees noted may not fit the profile of all palliative patients. They feared the loss of personal contact between medical staff and patients and favoured in-person conversation and on-site observations on site over the potential system. Interviewees saw potential in being able to discover unseen needs from some patients. Interviewees evaluated the system positively in the case that the system served to broadly orient care plans without affecting or reducing the patient-caregiver relationship.
A significant portion of the results touch upon the symbolic acceptance of the suggested system, which stands for an increasing standardisation and technisation of medicine where interpersonal contact and the professional expertise are marginalized. The study results can provide insight for processes and communication in the run-up to and during the implementation of electronic assessment systems.
肿瘤学和姑息治疗（PC）患者通常有复杂的需求，这需要综合的治疗方法。患者报告的结果（PROs）评估已被证明可以改善患者需求的识别，并促进治疗的调整。本研究探讨了医生和护士对计划中的 PROs 电子评估系统的职业常规、态度和期望。
对德国南部不同 PC 环境中的 10 名医生和 9 名护士进行了访谈。使用定性内容分析法对访谈进行了分析。
受访者对通过患者自我评估系统生成的数据质量持怀疑态度。他们批评了电子评估问卷的僵化性，认为这可能不适合所有姑息治疗患者的情况。他们担心医务人员和患者之间的个人联系会丧失，并赞成面对面的交流和现场观察，而不是潜在的系统。受访者认为，从一些患者身上发现潜在需求是有潜力的。受访者对该系统持积极态度，如果该系统有助于广泛指导护理计划，而不会影响或减少医患关系。
研究结果的很大一部分涉及对建议系统的象征性接受，这代表了医学的日益标准化和技术化，人际接触和专业知识被边缘化。研究结果可以为电子评估系统的实施前和实施过程中的流程和沟通提供参考。
