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将电子患者报告结局量表用于黑色素瘤常规护理中的痛苦筛查和生活质量评估的患者及工作人员体验:一项混合方法研究

Patient and Staff Experiences of Embedding Electronic Patient Reported Outcome Measures for Distress Screening and Quality of Life Assessment, Into Routine Melanoma Care: A Mixed-Methods Study.

作者信息

Dempsey Kathy, Saw Robyn, Bartula Iris, Lo Serigne N, Menzies Alexander M, Long Georgina V, Lawn Craig, Chung Julian, Pennington Thomas, Boyle Frances, Spillane Andrew, Dieng Mbathio, Saks Dina, Lai-Kwon Julia, Thompson Jake R, Morton Rachael L

机构信息

National Health & Medical Research Council (NHMRC) Clinical Trials Centre, The University of Sydney, Camperdown, Australia.

Melanoma Institute Australia, The University of Sydney, Sydney, Australia.

出版信息

Psychooncology. 2024 Dec;33(12):e70053. doi: 10.1002/pon.70053.

Abstract

OBJECTIVE

Patient reported outcome measures (PROMs) are commonly collected in melanoma research. However, they are not used to guide immediate clinical care in Australia. This study explored the views and experiences of patients with Stage III melanoma and clinic staff during implementation of an electronic Patient-Reported Outcome Measures in melanoma (ePROMs-MEL) pilot to assess distress and quality of life.

METHODS

A prospective mixed-methods study in specialist melanoma clinics in Sydney, Australia between May 2021 and February 2023. Forty-two post-ePROMs implementation surveys and 17 semi-structured interviews were undertaken among patients and staff (including oncologists, melanoma nurses and clinic managers). Survey responses were tabulated using Likert scales and interview transcripts analysed thematically.

RESULTS

Of the 31 patient survey responses, over 90% reported ePROMs were easy to complete and measured important components of their health and wellbeing. Of the 11 staff surveys, over 50% reported ePROMs to be useful when allied health referrals were accessible but found implementation disruptive to clinic workflows. Six themes about ePROMs in clinical care emerged during data analysis: (1) promoting self-reflection; (2) conversation-starters; (3) timing and setting; (4) fit for purpose questionnaires; (5) resource issues; (6) value and limitations of ePROMs.

CONCLUSION

Patients overwhelmingly supported the real-time collection of ePROMs for their immediate care. In contrast, staff support was conditional on resources to maximise clinical care efficiency and minimise administrative burden.

TRIAL REGISTRATION

Australia and New Zealand Clinical Trials Registry: anzctr.org.au/ACTRN12620001149954.aspx.

摘要

目的

患者报告结局指标(PROMs)在黑色素瘤研究中普遍收集。然而,在澳大利亚,它们并未用于指导即时临床护理。本研究探讨了III期黑色素瘤患者和临床工作人员在实施黑色素瘤电子患者报告结局指标(ePROMs-MEL)试点以评估痛苦和生活质量期间的观点和经历。

方法

2021年5月至2023年2月在澳大利亚悉尼的专科黑色素瘤诊所进行的一项前瞻性混合方法研究。对患者和工作人员(包括肿瘤学家、黑色素瘤护士和诊所经理)进行了42次ePROMs实施后调查和17次半结构化访谈。调查回复使用李克特量表制成表格,并对访谈记录进行主题分析。

结果

在31份患者调查回复中,超过90%的人报告ePROMs易于完成,并衡量了他们健康和幸福的重要组成部分。在11份工作人员调查中,超过50%的人报告说,当有联合健康转诊时,ePROMs很有用,但发现实施会扰乱诊所工作流程。数据分析过程中出现了关于临床护理中ePROMs的六个主题:(1)促进自我反思;(2)开启对话;(3)时间和环境;(4)适用的问卷;(5)资源问题;(6)ePROMs的价值和局限性。

结论

患者压倒性地支持为其即时护理实时收集ePROMs。相比之下,工作人员的支持取决于资源,以最大限度地提高临床护理效率并最小化行政负担。

试验注册

澳大利亚和新西兰临床试验注册中心:anzctr.org.au/ACTRN12620001149954.aspx

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