Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
J Patient Rep Outcomes. 2024 Jul 25;8(1):81. doi: 10.1186/s41687-024-00766-0.
Electronic patient-reported outcome (ePRO) systems can be used to engage patients in remote symptom monitoring to support postoperative care. We interviewed thoracic surgery patients with ePRO experience to identify factors that influenced use of ePROs to report their symptoms post-discharge.
This qualitative study used semi-structured telephone interviews with adults who underwent major thoracic surgery at an academic medical center in North Carolina. Individuals who enrolled in symptom monitoring, completed at least one ePRO survey, and were reachable by phone for the interview were included. The ePRO surveys assessed 10 symptoms, including validated Patient-Reported Outcome Common Terminology Criteria for Adverse Events (PRO-CTCAE) measures and thoracic surgery-specific questions. Surveys, offered via web-based and automated telephone options, were administered for four weeks post-discharge with alerts sent to clinicians for concerning symptoms. The interviews were guided by the Capability, Opportunity, Motivation model for behavior change (COM-B) and examined factors that influenced patients' completion of ePRO surveys post-discharge. Team members independently coded interviews and identified themes, informed by COM-B. We report descriptive statistics (demographics, number of surveys completed) and themes organized by COM-B components.
Of 28 patients invited, 25 (89%) completed interviews from July to October 2022. Participants were a median 58 years, 56% female, 80% White, and 56% had a history of malignancy. They completed 131/150 (87%) possible ePRO surveys. For capability, participants reported building ePROs into their routine and having the skills and knowledge, but lacking physical and emotional energy, to complete ePROs. For opportunity, participants identified the ease and convenience of accessing ePROs and providers' validation of ePROs. Motivators were perceived benefits of a deepening connection to their clinical team, improved symptom management for themselves and others, and self-reflection about their recovery. Factors limiting motivation included lack of clarity about the purpose of ePROs and a disconnect between symptom items and individual recovery experience.
Patients described being motivated to complete ePROs when reinforced by clinicians and considered ePROs as valuable to their post-discharge experience. Future work should enhance ePRO patient education, improve provider alerts and communications about ePROs, and integrate options to capture patients' complex health journeys.
电子患者报告结局（ePRO）系统可用于让患者参与远程症状监测，以支持术后护理。我们采访了有 ePRO 体验的胸外科患者，以确定影响他们使用 ePRO 报告出院后症状的因素。
这项定性研究使用了北卡罗来纳州一家学术医疗中心的成年人的半结构式电话访谈，这些成年人接受了主要的胸外科手术。被纳入症状监测、完成至少一项 ePRO 调查且可通过电话进行访谈的患者被纳入研究。ePRO 调查评估了 10 种症状，包括经过验证的患者报告结局常见术语标准不良事件（PRO-CTCAE）量表和胸外科特定问题。调查通过基于网络和自动电话选项在出院后四周内进行，当出现令人担忧的症状时，向临床医生发送警报。访谈以行为改变的能力、机会、动机模型（COM-B）为指导，检查了影响患者出院后完成 ePRO 调查的因素。团队成员独立对访谈进行编码，并根据 COM-B 确定主题。我们报告了描述性统计数据（人口统计学、完成的调查数量）和按 COM-B 组成部分组织的主题。
在邀请的 28 名患者中，有 25 名（89%）在 2022 年 7 月至 10 月期间完成了访谈。参与者的中位数年龄为 58 岁，56%为女性，80%为白人，56%有恶性肿瘤病史。他们完成了 131/150 份（87%）可能的 ePRO 调查。在能力方面，参与者报告说将 ePRO 纳入他们的日常工作中，并具备完成 ePRO 的技能和知识，但缺乏身体和情绪能量。在机会方面，参与者确定了访问 ePRO 的便利性和便利性，以及提供者对 ePRO 的验证。动机包括与临床团队建立更深入联系、改善自己和他人的症状管理以及对自己康复的自我反思的好处。限制动机的因素包括对 ePRO 目的缺乏明确性以及症状项目与个人康复经历之间的脱节。
患者描述说，当得到临床医生的强化时，他们有动力完成 ePRO，并认为 ePRO 对他们的出院后体验很有价值。未来的工作应该加强 ePRO 患者教育，改善关于 ePRO 的提供者警报和沟通，并整合选项以捕捉患者复杂的健康轨迹。
