Professionals’ views and experiences of using outcome measures in palliative care

Abstract

In palliative care, outcome measures are increasingly used to aid clinical practice, conduct audit and research. The objective of this study was to elicit professionals' views and experiences of using outcome measures, paying special attention to the Palliative care Outcome Scale (POS). This article presents the results of a qualitative study of 26 professionals, experienced in using the POS, who were invited to participate in semi-structured telephone interviews. Of those invited, 22 people took part. Participants' comments were noted verbatim through the interviews and data subjected to content analysis. Analysis of data identified a number of key themes surrounding outcome measures, notably their reasons for use, application in clinical settings and a range of professionals' attitudes. The article concludes that understanding the process of outcome measures is important for improving their implementation. When undertaking further research, attention should be paid to the wider social, cultural and structural contexts, as factors that can influence the implementation of outcome measures. As the drive towards outcome measures continues, it is essential that measures are not developed in a vacuum. Instead they should always be informed by the needs and experiences of individuals and services.

Functionality and feedback: a realist synthesis of the collation, interpretation and utilisation of patient-reported outcome measures data to improve patient care

“…Some participants noted that the POS was difficult to use when patients were too ill and that 'some patients feel that it is very intrusive' or found it 'confusing and upsetting'. 344 Some professionals also reported that they found some of the questions 'difficult to ask' or found the responses 'difficult to deal with'. 344 In response to this, the authors described how some professionals had altered the questions, ranging from 'vocabulary changes, to making more substantial revisions such as reworking questions or, in some cases, omitting certain questions and including new ones'.…”

“…344 In response to this, the authors described how some professionals had altered the questions, ranging from 'vocabulary changes, to making more substantial revisions such as reworking questions or, in some cases, omitting certain questions and including new ones'. 344 For example, one participant explained how they had omitted one of the questions to improve its usability in their local setting:…”

First assessments by specialist cancer nurses in the community: An ethnography

“…The specialist nurses were concerned about the timing of use of the SCC and had concerns about some of the items on the SCC and wished to avoid causing additional distress to patients (Hopkinson et al, 2006;Hughes et al, 2003). Patients may feel violated if they have shared sensitive information prematurely or against their wishes (Widang and Fridlund, 2003).…”

“…The barriers to using such tools in terms of specialist nurse attitudes need to be considered. Evidence of the effectiveness of the tools such as the SCC in terms of patient outcomes are needed as well as a consideration of training needs when incorporating these tools into practice (Hughes et al, 2003;Slater and Freeman, 2004).…”

“…Little is known about professionals' views and experiences of using assessment tools and some negative views have been reported about their use (Hughes et al, 2003;Baba et al, 2007). Issues found to be important when implementing assessment tools were time constraints, staff workload, training and the potential burden on the patient (Hughes et al, 2003;Dunckley et al, 2005).…”