Electronic Patient-Reported Outcome Measures (ePROMs) Improve the Assessment of Underrated Physical and Psychological Symptom Burden among Oncological Inpatients
by
, ,
Eva Warnecke
1, 
Maria Rosa Salvador Comino
1,
Dilara Kocol
2,
Bernadette Hosters
3,
Marcel Wiesweg
4,
Sebastian Bauer
4,
Anja Welt
4,
Anna Heinzelmann
1,
Sandy Müller
1,
Martin Schuler
4,
Martin Teufel
2 and
Mitra Tewes
1,* 1
Department of Palliative Medicine, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany
2
Department of Psychosomatic Medicine and Psychotherapy, West German Cancer Center, LVR-Klinikum Essen, University of Duisburg-Essen, 45122 Essen, Germany
3
Directorate of Nursing, University Hospital Essen, 45122 Essen, Germany
4
Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany
*
Author to whom correspondence should be addressed.
Cancers 2023, 15(11), 3029; https://doi.org/10.3390/cancers15113029
Submission received: 6 April 2023
/
Revised: 19 May 2023
/
Accepted: 29 May 2023
/
Published: 1 June 2023
(This article belongs to the Section Cancer Survivorship and Quality of Life)
Simple Summary
Professionals of the healthcare system face the challenge of providing suitable care delivery for inpatients with advanced cancer. External assessments, such as nurse-reported symptom burden, tend to underrate patients’ distress, as has already been shown in different studies. In contrast to that, patient-reported outcome measures (PROMs) have been shown to be effective as a systematic assessment; however, they are not yet implemented into daily routine. The aim of this retrospective study is to compare the information provided by PROMs and nurse-reported assessment to identify overlaps and differences in the current symptom burden. Therefore, collected data were analyzed from both PROMs and nurse-reported assessment from 230 inpatients of a major German Comprehensive Cancer Center. We discovered that some features of physical and psychological distress were underrated by nursing staff. Supplementing daily symptom assessment used by nursing staff with systematic ePROMs may improve the quality of supportive and palliative care of inpatients with advanced cancer.
Abstract
For advanced cancer inpatients, the established standard for gathering information about symptom burden involves a daily assessment by nursing staff using validated assessments. In contrast, a systematic assessment of patient-reported outcome measures (PROMs) is required, but it is not yet systematically implemented. We hypothesized that current practice results in underrating the severity of patients’ symptom burden. To explore this hypothesis, we have established systematic electronic PROMs (ePROMs) using validated instruments at a major German Comprehensive Cancer Center. In this retrospective, non-interventional study, lasting from September 2021 to February 2022, we analyzed collected data from 230 inpatients. Symptom burden obtained by nursing staff was compared to the data acquired by ePROMs. Differences were detected by performing descriptive analyses, Chi-Square tests, Fisher’s exact, Phi-correlation, Wilcoxon tests, and Cohen’s r. Our analyses pointed out that pain and anxiety especially were significantly underrated by nursing staff. Nursing staff ranked these symptoms as non-existent, whereas patients stated at least mild symptom burden (pain: meanNRS/epaAC = 0 (no); meanePROM = 1 (mild); p < 0.05; r = 0.46; anxiety: meanepaAC = 0 (no); meanePROM = 1 (mild); p < 0.05; r = 0.48). In conclusion, supplementing routine symptom assessment used daily by nursing staff with the systematic, e-health-enabled acquisition of PROMs may improve the quality of supportive and palliative care.
Keywords:
ePROMs; nurse-reported; symptom burden
