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结直肠癌护理连续过程中患者报告的体验和结局指标的应用:一项范围综述

Use of patient-reported experience and outcome measures within the colorectal cancer care continuum: a scoping review.

作者信息

Lau Jerrald, Ng Janelle Shaina, Lee Daphne, Tan Jarrod K-H, Tan Lydia Li-Yeh, Pang Ning-Qi, Tham Shi-Ying, Ng Chee-Kee, Tan Ker-Kan

机构信息

Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.

出版信息

J Cancer Surviv. 2024 Apr 16. doi: 10.1007/s11764-024-01595-2.

Abstract

OBJECTIVE

Patient-reported outcome measures (PROM) are frequently adopted to evaluate colorectal cancer (CRC) care, but the use of patient-reported experience measures (PREM) appears to be underdeveloped and not widely validated. This scoping review aims to understand the contexts for deployment of PREMs in CRC care, reliability of measures, gaps in current use of PREMs, and how PREMs are associated with PROMs when deployed together.

METHODS

Four scientific databases (PubMed, CINAHL, PsycINFO, Scopus) were systematically searched from January 2011 to December 2023. Observational or interventional studies involving quantitative or mixed methodology with samples consisting CRC patients undergoing screening, treatment, or cancer surveillance and utilizing at least one PREM as an exposure or outcome were included.

RESULTS

The initial search resulted in 10,400 records. Only 13 relevant studies (consisting of 17,105 participants) met the eligibility criteria. Utilization of PREMs was heterogenous across our sample and the CRC care continuum, and about half of the studies (53.8%) evaluated the relationship between PREMs and PROMs. PREM usage across the CRC care continuum largely focused on treatment/survivorship. Better care experience was positively associated with improved patient-reported outcomes.

CONCLUSIONS

Future work in CRC PREM development should focus on (1) establishing validated measures that aim to either capture disease/treatment-specific granularity or capitalize on applicability across care settings, (2) localizing novel or existing PREMs to consider different cultural contexts in healthcare, and (3) benchmarking associations between PREMs, PROMs, and other outcomes of interest.

IMPLICATIONS FOR CANCER SURVIVORS

Individuals progressing through the CRC care continuum often undergo a multitude of procedures from detection and diagnosis to treatment and surveillance. The establishment of validated PREMs specific to CRC would help to benchmark and further improve the quality of care received-which should translate to better patient-reported outcomes-and serve as process indicators for institutions and providers to maintain rigorous health service delivery standard for CRC survivors.

摘要

目的

患者报告结局测量(PROM)常用于评估结直肠癌(CRC)护理情况,但患者报告体验测量(PREM)的应用似乎尚不完善且未得到广泛验证。本范围综述旨在了解PREM在CRC护理中的应用背景、测量的可靠性、当前PREM使用中的差距,以及PREM与PROM一起使用时的关联情况。

方法

系统检索了2011年1月至2023年12月期间的四个科学数据库(PubMed、CINAHL、PsycINFO、Scopus)。纳入涉及定量或混合方法的观察性或干预性研究,样本包括接受筛查、治疗或癌症监测的CRC患者,且至少使用一种PREM作为暴露因素或结局指标。

结果

初步检索得到10400条记录。只有13项相关研究(共17105名参与者)符合纳入标准。在我们的样本和CRC护理连续过程中,PREM的使用情况各异,约一半的研究(53.8%)评估了PREM与PROM之间的关系。CRC护理连续过程中PREM的使用主要集中在治疗/生存阶段。更好的护理体验与改善的患者报告结局呈正相关。

结论

CRC领域PREM未来的研究工作应聚焦于:(1)建立经过验证的测量方法,旨在捕捉疾病/治疗的特定细节或利用其在不同护理环境中的适用性;(2)将新的或现有的PREM本地化,以考虑医疗保健中的不同文化背景;(3)确定PREM、PROM和其他相关结局之间的关联基准。

对癌症幸存者的意义

处于CRC护理连续过程中的个体通常要经历从检测、诊断到治疗和监测的众多程序。建立针对CRC的经过验证的PREM将有助于衡量并进一步提高所接受护理的质量,这应能转化为更好的患者报告结局,并作为机构和提供者为CRC幸存者维持严格医疗服务标准的过程指标。

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