PRO som bro til en helhedsorienteret tilgang til patienter med hæmatologiske kræftformer - En kritisk perspektivering
Published 2023-12-07
Versions
- 2023-12-07 (2)
- 2023-12-07 (1)
Keywords
- PRO,
- Hæmatologi,
- Sygepleje,
- Helhedsorienterede forløb,
- Anvendelsesorieteret forskning
How to Cite
Abstract
Introduction
There is evidence that communication between healthcare professionals and patients improves when Patient Reported Outcomes (PRO) are actively used in clinical consultations. PRO can contribute to person-centred and holistic care and treatment and supports shared decision making. Despite gaining ground in Danish hospitals, there is still a lack of knowledge about the potential of using PRO in nursing consultations with haematological patients undergoing longer courses of treatment and care.
Study: “PRO in practice”
Against this background, the Department of Haematology at Zealand University Hospital launched a multi-method study on PRO in practice to examine whether the use of PRO by nurses in practice supported a holistic approach to the care and treatment of patients diagnosed with chronic haematological cancers.
The study was a qualitative ethnographic study, taking place from 2016 to 2020. The analysis was inspired by Habermas’ critical theory.
Results
9 nurses were observed during consultations with patients and subsequently interviewed. The study showed that the nurses found the information they obtained via PRO data supportive of their work with care and treatment of patients. However, the nurses did not have frameworks or opportunities to actively use PRO during consultations in the time available, as they prioritised the time for discussion of blood tests and instrumental medical treatment.
Conclusion
It remains to be seen whether PRO can promote person-centred and holistic nursing care to patients with haematologic chronic cancers, and whether the use of PRO can be implemented within the current organisational frameworks and conditions in which nursing in a hospital context is practiced.
References
- Birkler, J., 2022. Sundhedsvæsenets ensidige fokus har tabt blikket for omsorgens kvalitet og værdi. Altinget.
- Börner, S., Petersen, N., Rosa, H., Stiegler, A., 2020. Paradoxes of late-modern autonomy imperatives: Reconciling individual claims and institutional demands in everyday practice. Br. J. Sociol. 71, 236–252. https://doi.org/10.1111/1468-4446.12731
- Claudius Welinder, P., 2021. Håndbog i sygepleje: Hæmatologi, 1. udgave. ed, Håndbøger / FADL’s Forlag. FADL, Roskilde.
- Cruz Rivera, S., Aiyegbusi, O.L., Ives, J., Draper, H., Mercieca-Bebber, R., Ells, C., Hunn, A., Scott, J.A., Fernandez, C. V, Dickens, A.P., Anderson, N., Bhatnagar, V., Bottomley, A., Campbell, L., Collett, C., Collis, P., Craig, K., Davies, H., Golub, R., Gosden, L., Gnanasakthy, A., Haf Davies, E., von Hildebrand, M., Lord, J.M., Mahendraratnam, N., Miyaji, T., Morel, T., Monteiro, J., Zwisler, A.-D.O., Peipert, J.D., Roydhouse, J., Stover, A.M., Wilson, R., Yap, C., Calvert, M.J., 2022. Ethical Considerations for the Inclusion of Patient-Reported Outcomes in Clinical Research: The PRO Ethics Guidelines. JAMA 327, 1910–1919. https://doi.org/10.1001/jama.2022.6421
- Damen, M.D.C., Westerweel, P.E., Levin, M.D., Pelle, A.J., 2022. Unmet supportive care needs, anxiety and depression in haematology patients during watch-and-wait. Psychooncology. 31, 176–184. https://doi.org/https://doi.org/10.1002/pon.5800
- Danske Patienter, VIBIS, 2016. Partnerskab om PRO [WWW Document]. URL https://danskepatienter.dk/vibis/inddragelse-i-eget-forloeb/pro-data/partnerskab-om-pro (accessed 6.22.22).
- Dobrozsi, S., Panepinto, J., 2015. Patient-reported outcomes in clinical practice. Hematol. Am. Soc. Hematol. Educ. Progr. 2015, 501–506. https://doi.org/10.1182/asheducation-2015.1.501
- Efficace, F., Gaidano, G., Lo-Coco, F., 2017. Perspective Patient-reported outcomes in hematology: is it time to focus more on them in clinical trials and hematology practice? Blood 130, 859–867. https://doi.org/10.1182/blood-2017-03-737403
- Goswami, P., Khatib, Y., Salek, S., 2019. Haematological malignancy: Are we measuring what is important to patients? A systematic review of quality-of-life instruments. Eur. J. Haematol. 102, 279–311. https://doi.org/10.1111/ejh.13203
- Habermas, J., 1982a. Theorie des kommunikativen Handelns. Bd. 1 : Handlungsrationalität und gesellschaftliche Rationalisierung, 2. Aufl. ed. Suhrkamp, Frankfurt am Main.
- Habermas, J., 1982b. Theorie des kommunikativen Handelns. Bd. 2 : Zur kritik der funktionalistischen Vernunft, 2. Aufl. ed. Suhrkamp, Frankfurt am Main.
- Hafliðadóttir, S.H., Juhl, C.B., Nielsen, S.M., Henriksen, M., Harris, I.A., Bliddal, H., Christensen, R., 2021. Placebo response and effect in randomized clinical trials: meta-research with focus on contextual effects. Trials 22, 493. https://doi.org/10.1186/s13063-021-05454-8
- Kjerholt, M., 2004. Omsorgssvigt i plejen til gamle - hvad og hvorfor, Publikation fra Institut for Sygeplejevidenskab, Aarhus Universitet, nr. 61/2004. Institut for Sygeplejevidenskab, Aarhus Universitet, Århus.
- Knoblauch, H., 2005. Focused Ethnography. Forum Qual. Sozialforsch. / Forum Qual. Soc. Res. 6, 44. https://doi.org/10.17169/fqs-6.3.20
- Langstrup, H., 2018. Patient-reported data and the politics of meaningful data work. Health Informatics J. 25, 567–576. https://doi.org/10.1177/1460458218820188
- McCormack, B., McCance, T., McCormack, B., 2016. Person-centred practice in nursing and health care: theory and practice, Second edi. ed. John Wiley & Sons Inc., Chichester, West Sussex.
- Partnerskab om PRO, Kræftens Bekæmpelse, 2017. Årsmagasin 2017. https://danskepatienter.dk/files/media/Publikationer - Eksterne/A_Danske Patienter %28eksterne%29/aarsmagasin_pro_2017.pdf.
- Scherber, R., Mesa, R.A., 2015. Survival and new cancers with myeloproliferative neoplasms. Lancet Haematol. https://doi.org/10.1016/S2352-3026(15)00109-X
- Sodemann, M., 2021. De raske har stukket de syge blår i øjnene. Vi har ikke ét sundhedsvæsen. Sundhedsmonitor.dk. https://sundhedsmonitor.dk/debat/art8282149/De-raske-har-stukket-de-syge-bl%C3%A5r-i-%C3%B8jnene.-Vi-har-ikke-%C3%A9t-sundhedsv%C3%A6sen.
- Sundhedsstyrelsen, 2015. Opfølgningsprogram for kroniske myeloide sygdomme.
- Thestrup Hansen, S., 2020. Patient-Reported Outcome Measures (PROMs) integrated in the follow-up of patients diagnosed with haematological cancers: A qualitative study of patients’ and health care professionals’ experiences [PhD thesis]. University of Southern Denmark, Odense. https://doi.org/10.21996/3ed4-9w37
- Thestrup Hansen, S., Kjerholt, M., Christensen, S.F., Brodersen, J., Hølge-Hazelton, B., 2020a. “I Am Sure That They Use My PROM Data for Something Important.” A Qualitative Study About Patients’ Experiences From a Hematologic Outpatient Clinic. Cancer Nurs. 43, E273–E282. https://doi.org/10.1097/NCC.0000000000000738
- Thestrup Hansen, S., Kjerholt, M., Friis Christensen, S., Brodersen, J., Hølge-Hazelton, B., 2021. Nurses’ Experiences When Introducing Patient-Reported Outcome Measures in an Outpatient Clinic: An Interpretive Description Study. Cancer Nurs. 44.
- Thestrup Hansen, S., Kjerholt, M., Friis Christensen, S., Brodersen, J., Hølge-Hazelton, B., 2020b. User experiences on implementation of patient reported outcome measures (PROMs) in a Haematological outpatient clinic. J. Patient-Reported Outcomes 4. https://doi.org/10.1186/s41687-020-00256-z
- Thestrup Hansen, S., Kjerholt, M., Friis Christensen, S., Hølge-Hazelton, B., Brodersen, J., 2019. Haematologists’ experiences implementing patient reported outcome measures (PROMs) in an outpatient clinic: a qualitative study for applied practice. J. Patient-Reported Outcomes 3, 74. https://doi.org/10.1186/s41687-019-0166-6