Use of health-related quality-of-life assessments in daily clinical oncology nursing practice: a community hospital-based intervention study.

摘要

BACKGROUND: The current study evaluated the efficacy of incorporating standardized health-related quality of life (HRQL) assessments as a routine part of the outpatient chemotherapy treatment of cancer patients in a community hospital in terms of: 1) facilitating nurse-patient communication, 2) increasing nurses' awareness of patients' HRQL, 3) patient management, 4) patients' satisfaction, and 5) patients' HRQL. METHODS: The study employed a sequential cohort design with repeated measures. Ten nurses and 219 patients participated in this community hospital-based study. The intervention involved patients completing standardized HRQL questionnaires via a touch-screen computer, the results of which were provided to nurses and patients in a graphic summary. Questionnaire and medical record data were used to assess outcomes. RESULTS: HRQL-related topics were discussed significantly more frequently in the intervention group than in the control group (mean = 4.8 topics vs 3.8 topics, respectively; P = .02). Nurses' awareness of patients' levels of daily activity, pain, and overall quality of life was significantly better in the intervention than the control group. The mean number of HRQL-related notations in the medical records was significantly higher in the intervention group (24 vs 20; P .05). Only modest effects were observed in patient management (counseling behavior), and no significant effects were found in patient satisfaction or changes in HRQL over time. CONCLUSIONS: Incorporating standardized HRQL assessments in daily clinical oncology nursing practice primarily facilitates the discussion of HRQL issues and increases nurses' awareness. Additional efforts are needed to enhance the effect of routine HRQL assessments on patient management and HRQL.