Title : Patient-Reported outcomes measurement as a tool for holistic attention
Abstract:
Nurses attend to their patients in a holistic way, as for our discipline patient is understood as a bio-psycho-social organism and not only as a person with a particular health problem. Nevertheless, health attention usually just focuses on the illness which causes the disorder, leaving aside the impact that the illness itself or its treatments may origins on the patient’s daily life. Patient-Reported outcomes measurement (PROMs) provide the valuation of the patient in a holistic way, since it allows the valuation of the psychological and social impact of the illnesses in the patient’ daily activities. Therefore PROMs encourages a sanitary system focused on patient as well as they align to the Evidence Based Clinical Practice (as it encourages the patient values and preferences) and it also line up with the Value Based Care (that states that sanitary attention must facilitate what really matters to the patient). Even though, PROMs improve the efficiency of the clinical consult (as health professionals are able to know how the patient is between one visit and another) and, therefore, the content of the consults may be restructure in order to treat those problems identified by the PROMs collected, promoting a proactive care. As this kind of attention requires the patient engagement, we developed a pilot qualitative study in order to explore the perception of patients diagnosed with breast cancer who attend to the University Hospital 12 de Octubre regarding the collection of health outcomes reported by patients as part of the clinical information for their assistance. Preliminary results showed that the main objective for patients when they are diagnosed with cancer is to survive. However, if the illness is overcome, women may have rejection feelings towards the treatment or its effects which will not be communicated because women think that the main objective have been achieved and collateral effects of treatment are secondary and, therefore, they should not be principal in any time. Nevertheless, this situation causes ambivalence in women who, on the one hand feel rejection to treatments and their consequences, and on the other hand deny themselves the possibility to express that reject. However, they stated they would appreciate if sanitary attention would consider these kind of topics that matter to them. So they would support the use of questionnaires with questions about these kind of tasks. Therefore, we achieved to know PROMs also ease the knowledge of information which is not usually told by the patient in consult. So, PROMs promote not only a better and holistic knowledge of the patient, but also they ease the development of empathy among health professionals, since they are aware of the difficulties that illnesses and their treatments might cause on the patients’ daily life. Both of them are considered as added values for university hospitals, were health professionals learn how to care their future patients.
Take Away Notes:
• PROMs allow us to evaluate the patient adherence to treatment, as it provides information about the side effects of the treatments and how they might have an impact on the patient’ daily life activities. Thus, they will also provide useful information in order to review or redesign process and protocols so that they could be aligned with the patient centered care models. Hence, PROMs also will improve our knowledge about our attention process and their outcomes
• Besides, the systematic collection of PROMs will make easer to explode data in order to perform research studies and it will also information to allow benchmarking among different centers
• As PROMs provides significant information for continuity of care, it is possible to make a praecox diagnosis of problems that might not have been identified neither by the patient nor by the health professionals during ordinary attention. Therefore, PROMs are also a very useful tool for Health Education
