Department of Plastic and Breast Surgery, Zealand University Hospital, Sygehusvej 10, 4000, Roskilde, Denmark; Department of Regional Health Research, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
Clinical Nursing Research Unit, Aalborg University Hospital, Sdr. Skovvej 15, 9000, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Niels Jernes Vej 10, 9220, Aalborg Ø, Denmark.
Eur J Oncol Nurs. 2024 Dec;73:102712. doi: 10.1016/j.ejon.2024.102712. Epub 2024 Oct 19.
This study aimed to investigate patients' experiences with electronic Patient-Reported Outcome Measures (ePROMs) during follow-up consultations with registered nurses and surgeons in breast cancer care.
A qualitative approach was employed, using focused ethnography with participant observations during patient consultations at a Plastic and Breast Surgery outpatient clinic, followed by individual interviews with the patients. Data were analysed using reflexive thematic analysis by Braun and Clarke. The discussion was informed by theory on person-centred practice.
A total of 38 participants were included. ePROMs strengthened person-centred practice by nudging patients to reflect on their health, voice their concerns and engage in active dialogue during consultations, particularly regarding body image issues. The relevance and impact of ePROMs were highly dependent on the timing of the patient's treatment trajectory. Patients found that ePROMs were more meaningful and contextually appropriate when completed during late follow-up. This could be because patients faced challenges with ePROMs, including not understanding their purpose, the need for assistance from relatives and instances when ePROMs were not integrated into consultations.
ePROMs can empower patients by facilitating meaningful discussions about body image and other concerns during postoperative follow-up consultations. However, their effectiveness relies on clear communication and proper integration into clinical practice. The results add to existing litterature by highlighting the dual impact of ePROMs, as they can enhance patient-centred care but also present challenges when their purpose is unclear. The implications for future practice include the need to develop strategies that engage diverse patient groups in the ePROM process, supporting equal access to follow-up care and addressing health disparities.
本研究旨在调查患者在乳腺癌护理中接受注册护士和外科医生随访时使用电子患者报告结局测量（ePROM）的体验。
采用定性方法，在整形和乳腺外科门诊就诊期间进行参与者观察的聚焦民族志研究，随后对患者进行个体访谈。使用 Braun 和 Clarke 的反思性主题分析对数据进行分析。讨论以以人为本的实践理论为依据。
共纳入 38 名参与者。ePROM 通过促使患者反思自己的健康状况、表达关注并在咨询期间积极参与对话，特别是在涉及身体形象问题时，增强了以人为本的实践。ePROM 的相关性和影响高度取决于患者治疗轨迹的时间。当患者在晚期随访时完成 ePROM 时，他们发现 ePROM 更有意义且更符合上下文。这可能是因为患者在使用 ePROM 时遇到了挑战，包括不理解其目的、需要亲戚的帮助以及 ePROM 未纳入咨询的情况。
ePROM 通过促进术后随访咨询中有关身体形象和其他问题的有意义讨论，从而增强患者的能力。然而，其有效性依赖于明确的沟通和适当的整合到临床实践中。研究结果通过强调 ePROM 的双重影响，补充了现有文献，因为它们可以增强以患者为中心的护理，但当其目的不明确时也会带来挑战。对未来实践的影响包括需要制定策略，让不同的患者群体参与 ePROM 过程，支持平等获得随访护理，并解决健康差异。
