Department of Surgery, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
School for Oncology and Developmental Biology (GROW), Maastricht University, Maastricht, The Netherlands.
Support Care Cancer. 2021 Sep;29(9):5253-5261. doi: 10.1007/s00520-021-06052-9. Epub 2021 Mar 2.
In the last decades, the number of cancer survivors has increased significantly due to improved treatment and better detection of recurrence. This increased survival redirects the scope from survival towards optimising functional outcomes and improving health-related quality of life (HRQol). Functional and HRQoL outcomes can be assessed with patient-reported outcome measures (PROMs). However, the use of PROMs in daily oncological care is not common. This qualitative study investigates the barriers and facilitators of PROM use in an oncological setting, from the perspective of the healthcare professionals (HCPs).
Individual semi-structured interviews were conducted among Dutch oncological HCPs. Barriers and facilitators of PROM implementation were identified on various levels of the healthcare system (i.e. level of the patient, individual professional, medical team, and healthcare organisation). Interviews were audio recorded and transcribed verbatim. Transcripts were manually analysed by two independent reviewers using a thematic approach. Identified barriers and facilitators were categorised into Grol and Wensing's framework for changing healthcare practice.
Nineteen oncological HCPs working in academic and non-academic hospitals were interviewed. Barriers for PROM implementation were lack of good IT support, lack of knowledge on how to use PROMs, lack of time to complete and interpret PROMs, and a high administrative burden. PROM implementation can be facilitated by providing clear guidance regarding PROM interpretation, evidence that PROMs can save time, and stimulating multidisciplinary teamwork.
From a HCP point of view, adequately functioning IT technology, sufficient knowledge on PROMs, and dedicated time during the consultation are essential for successful implementation of PROMs in oncological care. Additional local context-specific factors need to be thoroughly addressed.
由于治疗效果的提高和复发检测的改善，过去几十年来癌症幸存者的数量显著增加。这种生存的增加将关注点从生存转向优化功能结果和提高健康相关生活质量（HRQoL）。功能和 HRQoL 结果可以通过患者报告的结果测量（PROMs）来评估。然而，在肿瘤学护理中使用 PROM 并不常见。这项定性研究从医疗保健专业人员（HCPs）的角度调查了肿瘤学环境中使用 PROM 的障碍和促进因素。
对荷兰肿瘤学 HCPs 进行了个体半结构化访谈。在医疗保健系统的各个层面（即患者层面、个体专业层面、医疗团队层面和医疗保健组织层面）确定了 PROM 实施的障碍和促进因素。访谈进行了录音，并逐字转录。两名独立审查员使用主题方法对转录本进行手动分析。确定的障碍和促进因素被归类为 Grol 和 Wensing 的改变医疗实践框架。
采访了 19 名在学术和非学术医院工作的肿瘤学 HCPs。PROM 实施的障碍包括缺乏良好的 IT 支持、缺乏使用 PROM 的知识、缺乏完成和解释 PROM 的时间以及行政负担过重。通过提供有关 PROM 解释的明确指导、证据表明 PROM 可以节省时间以及激励多学科团队合作，可以促进 PROM 的实施。
从 HCP 的角度来看，功能齐全的 IT 技术、足够的 PROM 知识以及咨询期间的专用时间对于在肿瘤学护理中成功实施 PROM 至关重要。还需要彻底解决其他特定于当地情况的因素。
