School of Nursing, Fudan University, China.
Pediatric Surgical Oncology Unit, Children's Hospital of Fudan University, China.
J Pediatr Nurs. 2020 Nov-Dec;55:100-109. doi: 10.1016/j.pedn.2020.07.005. Epub 2020 Jul 31.
Patient-reported outcomes (PROs) are increasingly recognized in pediatric clinical care as adding essential information relevant to actual care. However, the effectiveness of using PROs in pediatric clinical settings has not been fully explored with synthesized evidence. The aim of this study was to evaluate the effectiveness of using patient-reported outcomes in pediatric clinical practices.
We searched four English and three Chinese databases to identify studies that examine the effectiveness of using PROs in pediatric clinical practices published from the inception date of each database to January 2020.
Ten articles met the inclusion criteria.
There was wide a variation in the ten studies' designs, samples, PROs administered (type, length, timing, mode), and type of outcomes evaluated. The effect sizes of using PROs on three categories of outcomes (patient, process of care and health service) were assessed. Of 70 measured outcomes, 32 were positive, 5 were negative, and 33 were mixed.
Overall, there is a weak but trending positive impact of using PROs in pediatric clinical practice.
More rigorous study designs with sources of bias controlled are needed to more directly assess the impact of using PROs in pediatric care. If findings continue to be positive, then an implementation model addressing the numerous influencing factors is recommended to integrate PROs into pediatric care.
患者报告的结果（PROs）在儿科临床护理中越来越被认为是提供与实际护理相关的重要信息。然而，使用 PROs 在儿科临床环境中的有效性尚未通过综合证据充分探索。本研究旨在评估在儿科临床实践中使用患者报告结果的效果。
我们检索了四个英文数据库和三个中文数据库，以确定从每个数据库的创建日期到 2020 年 1 月发表的研究，这些研究检验了在儿科临床实践中使用 PROs 的效果。
符合纳入标准的有 10 篇文章。
这 10 项研究的设计、样本、管理的 PROs（类型、长度、时间、模式）以及评估的结果类型存在很大差异。使用 PROs 对三个类别的结果（患者、护理过程和卫生服务）的效果大小进行了评估。在 70 个测量的结果中，32 个是阳性的，5 个是阴性的，33 个是混合的。
总体而言，在儿科临床实践中使用 PROs 具有微弱但呈上升趋势的积极影响。
需要采用具有控制偏倚来源的更严格的研究设计，以便更直接地评估在儿科护理中使用 PROs 的影响。如果发现持续呈阳性，那么建议采用一个解决众多影响因素的实施模型，将 PROs 纳入儿科护理。
