使用综合姑息治疗结果量表（IPOS）和 NCCN 压力温度计对非治愈癌症门诊患者进行真实情况下的患者报告结果测量（PROM）--一项混合方法研究

PEC innovation Pub Date : 2024-02-12 DOI:10.1016/j.pecinn.2024.100264

Eileen Ratzel , Ina Maria Pretzell , Thomas Kindler , Martin Weber , Christina Gerlach

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引用次数: 0

摘要

目的：进行前瞻性队列研究，测试综合癌症中心门诊不可治愈的肺癌或前列腺癌患者所需的纵向患者报告结果测量 PROM（综合姑息结果量表 IPOS 和 NCCN 痛苦温度计 DT）在现实生活中的可行性。方法：对纸质 IPOS 和 DT 进行为期 15 个月的评估。我们分析了 PROM 之后对患者痛苦（请求支持和姑息服务）的反应。结果97%（125/129）的患者接受了一次问卷调查，但只有 50% 和 31% 的前列腺癌和肺癌患者实现了认证委员会建议的季度评估。虽然两种工具都得到了广泛认可，但只有 IPOS 显示出较高的内容效度，因为一些患者在理解 DT 方面存在困难。患者对填写 PROM 感觉舒适，而 HCP 发现 PROM 有助于安排与患者的接触。由于在处理工具和对已识别的痛苦反应的操作方面存在组织缺陷，转诊到支持性和姑息服务的情况很少。

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Patient Reported Outcome Measurement (PROM) under real-life conditions of non-curable cancer outpatients with the Integrated Palliative Outcome Scale (IPOS) and NCCN-Distress Thermometer – A mixed methods study

Objective

Prospective cohort study to test the real-life feasibility of longitudinal patient-reported outcome measurement PROM (Integrated Palliative Outcome Scale IPOS, and NCCN Distress Thermometer DT) required for outpatients with non-curable lung or prostate cancer in comprehensive cancer centers.

Methods

Assessment with paper-based IPOS and DT was observed for 15 months. We analyzed response to patients' distress (requests for supportive and palliative services) following PROM. Focus groups to comprehensively explore the user experience of patients, informal caregivers and health care professionals (HCP) supplemented the analysis.

Results

Ninety-seven percent (125/129) of the patients received a questionnaire once, but quarterly assessment as recommended by certification committees was achieved only in 50% and 31% of prostate and lung cancer patients. Although both instruments were well accepted, only IPOS showed a high content validity, because some patients had difficulties in understanding the DT. Patients felt comfortable with completing the PROM, and HCP found PROM helped to structure the patient encounter. Due to organizational deficiencies in the handling of the instruments and operationalization of reactions to identified distress, the referrals to supportive and palliative services were rare.