Sibert Nora Tabea, Kowalski Christoph, Pfaff Holger, Wesselmann Simone, Breidenbach Clara
German Cancer Society, Kuno-Fischer-Straße 8, 14057, Berlin, Germany.
University of Cologne, Faculty of Human Sciences, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Eupener Str. 129, 50933, Köln, Germany.
BMC Health Serv Res. 2021 Apr 20;21(1):366. doi: 10.1186/s12913-021-06361-z.
Patient-reported outcomes (PROs) can be used in cancer care to monitor patients' disease-related symptoms and functional status. However, successful implementation of such instruments is only possible if clinical staff are convinced of the clinical benefits. It is therefore crucial to investigate the attitudes of clinical staff to PROs in routine cancer care.
Semi-structured, guideline-based interviews were held with 12 clinicians working in certified colorectal cancer centers in Germany who are taking part in an observational study on PROs (five surgeons, two oncologists, one psycho-oncologist, two oncological care nurses, one stoma therapist, and one physician assistant) in order to investigate firstly, how clinicians describe PRO instruments ("wording"); and secondly, the clinicians' general attitude toward PROs. A qualitative content analysis according to Kuckartz was performed.
The wording used to describe PROs was not consistent. Statements on attitudes toward PROs were very heterogeneous and were therefore categorized into "(rather) positive" and "(rather) negative." The principal advantages of PROs mentioned by participants included broader, structured knowledge about patients and treatment, as well as relevance for patients. Subcategories for (rather) negative attitudes included statements expressing doubts about the questionnaires and "no need for PROs."
The clinicians participating mainly expressed fairly positive attitudes toward PROs. However, they had little knowledge about PROs in general and the interviews therefore mainly reflect their expectations and assumptions about them. These initial impressions may be regarded as providing a basis for future implementation strategies and for training of clinicians on how to use PROs in routine cancer care.
患者报告结局（PROs）可用于癌症护理，以监测患者与疾病相关的症状和功能状态。然而，只有临床工作人员确信其临床益处，此类工具才能成功实施。因此，调查临床工作人员在常规癌症护理中对PROs的态度至关重要。
对德国认证结直肠癌中心参与PROs观察性研究的12名临床医生进行了基于指南的半结构化访谈（5名外科医生、2名肿瘤学家、1名心理肿瘤学家、2名肿瘤护理护士、1名造口治疗师和1名医师助理），以便首先调查临床医生如何描述PRO工具（“措辞”）；其次，调查临床医生对PROs的总体态度。根据库卡茨进行了定性内容分析。
用于描述PROs的措辞不一致。关于对PROs态度的陈述非常多样，因此分为“（相当）积极”和“（相当）消极”两类。参与者提到的PROs的主要优点包括对患者和治疗有更广泛、结构化的了解，以及与患者的相关性。（相当）消极态度的子类别包括对问卷表示怀疑的陈述和“不需要PROs”。
参与的临床医生主要对PROs表达了相当积极的态度。然而，他们总体上对PROs了解甚少，因此访谈主要反映了他们对PROs的期望和假设。这些初步印象可被视为为未来的实施策略以及培训临床医生如何在常规癌症护理中使用PROs提供了基础。
