[在一家大型肿瘤中心的常规护理中使用 ePRO:结果与经验]。

IF 1.4 Q4 HEALTH POLICY & SERVICES
Martin Eichler, Leopold Hentschel, Beate Hornemann, Markus Schuler, Stephan Richter, Friedegund Meier, Jürgen Weitz, Klaus-Dieter Schaser, Mechthild Krause, Anke Mütherig, Tina Thomas, Sandra Weigmann-Faßbender, Roman Schmädig, Anke Rentsch, Heike Vetter, Matthias Kemmerer, Gerhard Ehninger, Maria Eberlein-Gonska, Jochen Schmitt, Martin Bornhäuser, Christine Hofbauer
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引用次数: 0

摘要

背景:通过电子方式获取的患者报告结果(ePRO)在多大程度上以及在何种条件下可用于常规医疗护理,并有助于改善患者护理,这是一个被广泛讨论的问题。在肿瘤学领域,德国很少有超越限时研究范围的研究关注这一主题:首先,我们介绍了德国癌症援助组织综合癌症中心在常规医疗中集中协调收集电子病历的发展过程,然后描述了其定性维度。随后,我们使用 "实施研究综合框架 "对干预措施进行了讨论:自 2019 年开始实施以来,肿瘤中心跨学科门诊的 2000 多名患者接受了调查。每月受访人数在 19 至 65 人之间。在报告期的五年间,对内容和使用目的以及技术和人员结构进行了多次调整。始终如一的使用目的是筛查支持性需求,最初与肿瘤心理治疗有关,后来扩展到体育疗法、戒烟计划、社会和营养咨询。所使用的工具也相应不同;与健康相关的生活质量和心理压力一直是调查内容:讨论:在肿瘤常规治疗中成功使用 ePRO 需要人力和技术资源以及高度的适应性。在我们的病例中,跨学科癌症中心集中协调 ePRO 收集工作的复杂性尤为重要。在实施过程中,需要考虑最初决定(如调查软件)所产生的路径依赖性。人们对干预措施持保留态度,意见领袖对成功部署的重要性也有目共睹。德国肿瘤中心认证体系等外部条件被证明是另一个相关因素:总之,该分析研究了医院系统正在进行的数字化进程中的一个环节,其目的是为患者提供以需求为基础的个性化医疗服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[ePROs in the routine care of a major oncology center: Results and experiences].

Background: To what extent and under what conditions electronically captured patient-reported outcomes (ePROs) can be used in routine medical care and contribute to improved patient care is a widely discussed question. In the field of oncology, few studies in Germany have focused this topic that go beyond the scope of time-limited studies.

Method: First, we present the centrally coordinated collection of ePROs in the routine care of a comprehensive cancer center of the German Cancer Aid in its development, and then describe its qualitative dimension. Subsequently, the intervention is discussed using the Consolidated Framework of Implementation Research.

Results: Since the implementation started in 2019, over 2,000 patients from the interdisciplinary outpatient clinic of the oncology center have been surveyed. The number of respondents varied between 19 and 65 per month. Over the five years of the reporting period, numerous adjustments have been made regarding content and usage purposes as well as technical and personnel structures. The consistent purpose of use was screening for supportive needs, initially related to psycho-oncology, later expanded to include sports therapy, smoking cessation programs, social and nutritional counseling. The instruments used varied accordingly; health-related quality of life and psychological stress were consistently surveyed.

Discussion: Successful use of ePROs in oncological routine care requires personnel and technical resources as well as a high degree of adaptability. In our case, the complexity of a centrally coordinated ePRO collection within an interdisciplinary cancer center is of particular importance. Path dependencies arising from initial decisions, such as the survey software, need to be considered during implementation. Reservations about the intervention and the importance of opinion leaders for successful deployment have been observed. External conditions such as the certification system of oncology centers in Germany proved to be another relevant factor.

Conclusion: Overall, the analysis examines a segment of the ongoing digitization process of the hospital system directed towards needs-based, individualized patient care.

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CiteScore
1.90
自引率
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