Objectives

Patient-reported outcome (PRO) measures are commonly used in clinical practice, and an important aspect is how healthcare professionals use these measures to make clinical decisions. This study aimed 1) to understand how remote electronic symptom monitoring using PRO measures can support oncology nurses' clinical decision-making in patients with metastatic lung cancer and 2) to explore factors that potentially can influence how remote symptom monitoring supports clinical decision-making.

Data Sources

A qualitative approach using semistructured interviews was conducted with 18 registered nurses working with remote symptom monitoring at oncology departments at eight Danish hospitals.

Conclusion

Nurses reported that remote symptom monitoring supports clinical decision-making because it assisted in identifying relevant problems, monitoring relevant changes over time, and prompting relevant clinical actions. Factors that affected how remote symptom monitoring could support clinical decision-making were access to supplemental information, the trustworthiness of PRO data, nursing competencies and responsibilities, working conditions, and care at a distance.

Implication for Nursing Practice

The use of PRO data in the clinical decision-making process is highly dependent on the nurses' professional competencies, the organizational structure, and the trustworthiness of PRO data. Thus, we recommend considering these factors before implementing PRO data in routine care. For example, train clinical staff in using PRO data in their clinical decision-making, develop guidance for how to use PRO data with other forms of data to make sound clinical actions, and ensure that organizational resources are sufficient.

中文翻译：

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探讨护士在转移性肺癌患者临床决策中使用远程电子症状监测的观点

目标

患者报告结果 (PRO) 衡量标准在临床实践中常用，一个重要方面是医疗保健专业人员如何使用这些衡量标准做出临床决策。本研究的目的是 1) 了解使用 PRO 措施的远程电子症状监测如何支持肿瘤科护士对转移性肺癌患者的临床决策；2) 探索可能影响远程症状监测如何支持临床决策的因素。

数据源

采用半结构化访谈的定性方法对 18 名在丹麦八家医院肿瘤科从事远程症状监测工作的注册护士进行了研究。

结论

护士报告说，远程症状监测支持临床决策，因为它有助于识别相关问题，监测一段时间内的相关变化，并提示相关的临床行动。影响远程症状监测如何支持临床决策的因素包括补充信息的获取、PRO 数据的可信度、护理能力和责任、工作条件以及远程护理。

对护理实践的启示

PRO数据在临床决策过程中的使用高度依赖于护士的专业能力、组织结构以及PRO数据的可信度。因此，我们建议在常规护理中实施 PRO 数据之前考虑这些因素。例如，培训临床工作人员在临床决策中使用 PRO 数据，制定如何将 PRO 数据与其他形式的数据结合使用以做出合理的临床行动的指南，并确保组织资源充足。