医护人员对患者报告结局认知和态度的质性研究

Cognition and attitude of Chinese medical staff on patient-reported outcomes:A qualitative study

目的了解国内医护人员对患者报告结局的认知和态度,为患者报告结局在临床的推广和应用提供参考。方法采用目的性选样法选取10名医护人员进行半结构性访谈,应用Claizzi现象学资料7步分析法分析资料。结果经编码和提炼,得出4大主题共14个类属:(1)新概念:“接触较少”“概念不清”。(2)肯定价值:“帮助全面评估”“辅助医疗决策”“尊重主观体验”“丰富科研数据”“改善医患关系”。(3)认知疑惑:“增加工作量”“干扰判断”“翻译差异”“评价方法”。(4)应用困难:“填写质量”“患者意愿”“中国国情”。结论受访医护人员对患者报告结局这一理念普遍持积极和开放的态度,但对患者报告结局的认知程度较低,今后需加强医护人员对患者报告结局认知的相关培训,并针对医护人员提出的可能存在的应用困难开展更深入的临床研究,研发方便实施和推广的应用工具,制定科学可行的应用方案,以促进患者报告结局在临床的落地。

Objective To understand the cognition and attitude of domestic medical staff to PROs,and to provide reference for the promotion and application of PROs in clinic.Methods Semi-structured interviews were conducted to 10 medical staff selected by purposive sampling.Claizzi’s 7-step analysis of phenomenological data was adopted to analyze the data.Results Four themes including totally 14 subthemes were extracted:(1)new concept:“less contact”and“unclear concept”.(2)positive value:“promote comprehensive evaluation”,“assist medical decision making”,“respect subjective experience”,“enrich scientific data”and“improve clinician-patient relationship”.(3)cognitive confusion:“add to workload”,“interfere judgement”,“translation differences”and“evaluation method”.(4)difficulties in application:“quality of questionnaire filling”,“patients’willingness”and“national conditions”.Conclusions The medical staff interviewed generally held a positive and open attitude towards PROs,while their knowledge about PROs was limited.They are not clear enough about the related concepts and their relationships and still have some perplexities about the specific mode of clinical application of PROs.The research results indicate us to strengthen relevant training on PROs in domestic medical staff,to carry out more in-depth exploration in view of the obstacles of PROs implementation,to develop PROs measurement tools that are convenient to implement and popularize,and to identify scientifically feasible clinical application modes to escort PROs landed in the clinic.