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Implementing person-centred outcome measures in palliative care: An exploratory qualitative study using Normalisation
Andy Bradshaw1, Martina Santarelli1, Malene Mulderrig1
1Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK.
Palliative Medicine
|November 30, 2020
Summary
Implementing Person-Centred Outcome Measures in palliative care is challenging. Normalisation Process Theory explains how individual and organizational factors influence successful integration for better symptom management.
Area of Science:
- Palliative Care
- Health Services Research
- Implementation Science
Background:
- Implementing Person-Centred Outcome Measures (PCOMs) in palliative care is crucial but challenging.
- Existing research often identifies barriers without explaining the underlying causal mechanisms.
- Implementation theories are underutilized in palliative care outcomes research.
Purpose of the Study:
- To apply Normalisation Process Theory (NPT) to understand implementation mechanisms of PCOMs in palliative care.
- To identify factors enabling or hindering the routine use of PCOMs.
Main Methods:
- Exploratory qualitative study design.
- Data collection via semi-structured interviews with healthcare professionals.
- Framework approach used for data analysis.
Main Results:
- Seven themes identified, detailing causal mechanisms for PCOM implementation.
- Key themes include measure subjectivity, frequency of use, training, community engagement, system readiness, communication, and demonstrating value.
- Implementation factors operate at both individual and organizational levels.
Conclusions:
- Addressing identified individual and organizational factors is essential for successful PCOM integration.
- Facilitating PCOM use enhances systematic symptom identification, management, and measurement for patients.
- Provides practical questions to guide the integration of outcome measures into routine palliative care.
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