SEARCHCOHORToncology, internal medicine

cohort·oncology, internal medicine, research methods, observational study·PMC10252046

Electronic Patient-Reported Outcome Measures (ePROMs) Improve the Assessment of Underrated Physical and Psychological Symptom Burden among Oncological Inpatients

Cancers · 12 authors, 4 centres

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TL;DR

This retrospective study compared nurse-reported symptom burden with electronic patient-reported outcome measures (ePROMs) in 230 cancer inpatients. It found that nursing staff significantly underrated symptoms of pain and anxiety compared to patients' self-reports.

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This retrospective, non-interventional, monocentric study analyzed data from 230 oncological inpatients to compare symptom burden reported by nursing staff (using epaAC) with that reported by patients via ePROMs. Descriptive analyses and non-parametric statistical tests (Chi-Square, Fisher’s exact, Wilcoxon) were used. The central result was that nursing staff significantly underrated the severity of pain and anxiety; for both, the mean nurse-reported score indicated no symptom, while the mean ePROM score indicated mild symptom burden (p < 0.05). Limitations include the monocentric design and potential bias from a high number of incomplete ePROMs.

STUDY TYPE

cohort

SPECIALTY

oncology

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ORIGINAL PAPER

PMC10252046

Electronic Patient-Reported Outcome Measures (ePROMs) Improve the Assessment of Underrated Physical and Psychological Symptom Burden among Oncological Inpatients

Cancers

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ABSTRACT

Abstract 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: mean NRS/epaAC = 0 (no); mean ePROM = 1 (mild); p < 0.05; r = 0.46; anxiety: mean epaAC = 0 (no); mean ePROM = 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

CITATION EXPORT

Eva Warnecke, Maria Rosa Salvador Comino, Dilara Kocol et al.. Electronic Patient-Reported Outcome Measures (ePROMs) Improve the Assessment of Underrated Physical and Psychological Symptom Burden among Oncological Inpatients. Cancers. (2023). https://doi.org/10.3390/cancers15113029

AUTHORS

12 · 4 CENTRES

Eva Warnecke, Maria Rosa Salvador Comino, Dilara Kocol, Bernadette Hosters, Marcel Wiesweg, Sebastian Bauer, Anja Welt, Anna Heinzelmann, Sandy Müller, Martin Schuler, Martin Teufel, Mitra Tewes

1Department of Palliative Medicine, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany; [email protected] (E.W.);
2Department of Psychosomatic Medicine and Psychotherapy, West German Cancer Center, LVR-Klinikum Essen, University of Duisburg-Essen, 45122 Essen, Germany
3Directorate of Nursing, University Hospital Essen, 45122 Essen, Germany
4Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, 45122 Essen, Germany