Related Experiment Video
Updated: Aug 31, 2025
E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Patient-reported outcome measures in pediatric asthma care: using theoretical domains framework to explore healthcare
Sumedh Bele1,2,3, Sarah Rabi4, Muning Zhang5
1Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Insights
Implementing patient-reported outcome measures (PROMs) in pediatric asthma clinics faces barriers like limited awareness and system factors. Electronic administration and provider commitment are key enablers for successful PROM integration.
Area of Science:
- Implementation Science
- Health Services Research
- Pediatric Healthcare
Background:
- Patient-reported outcome measures (PROMs) are crucial for patient-centered care.
- Implementing PROMs requires significant behavioral changes from healthcare stakeholders.
- Understanding these changes is vital for successful integration into clinical practice.
Purpose of the Study:
- To identify barriers and enablers to implementing PROMs in pediatric outpatient asthma clinics.
- To utilize the Theoretical Domains Framework (TDF) for a systematic inquiry.
- To inform the development of the KidsPRO electronic platform.
Main Methods:
- Qualitative descriptive study using semi-structured interviews.
- 17 participants including pediatricians, nurses, allied health, and administrative staff.
- Interviews were transcribed, coded, and themed using the TDF.
Main Results:
- 33 themes identified across 14 TDF domains.
- 16 barriers and 17 enablers to PROM implementation were categorized.
- Barriers included awareness, language, and family factors; enablers included electronic administration and personal commitment.
Conclusions:
- The study captured the complexity of implementing PROMs in pediatric asthma care.
- Findings highlight the importance of addressing personal, clinical, and system-level factors.
- Results are applicable to other pediatric settings, informing broader implementation strategies.
Background:
Patient-reported outcome measures (PROMs) play an important role in promoting and supporting patient and family-centered care. Implementing interventions like PROMs in routine clinical care require key stakeholders to change their behavior. The aim of this study was to utilize the Theoretical Domains Framework (TDF) to identify barriers and enablers to the implementation of PROMs in pediatric outpatient asthma clinics from healthcare providers' perspective.
Methods:
This TDF-guided qualitative descriptive study is part of a larger multi-phase project to develop the KidsPRO program, an electronic platform to administer, collect, and use PROMs in pediatrics. Semi-structured qualitative interviews were conducted with 17 participants, which included pediatricians, nurses, allied health professionals and administrative staff from outpatient asthma clinics. All the interviews were transcribed, deductively coded, inductively grouped in themes, and categorized into barriers and enablers.
Results:
We identified 33 themes within 14 TDF domains, which were further categorized and tabulated into 16 barriers and 17 enablers to implementing PROMs in asthma clinics. Barriers to behavioral change were attributed to personal, clinical, non-clinical, and other system-level factors; they ranged from limited awareness of PROMs to language barriers and patient's complex family background. Enablers ranged from a personal commitment to providing patient and family-centered care to administering PROMs electronically.
Conclusion:
This implementation of science-based systematic inquiry captured the complexity of PROMs implementation in pediatric outpatient clinical care for asthma. Considering the consistency in barriers and enablers to implementing PROMs across patient populations and care settings, many findings of this study will be directly applicable to other pediatric healthcare settings.
Related Concept Videos
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:30Asthma-IV: Nursing Management
First, in...
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:23Assessment of Respiration
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
01:24Asthma-III: Symptoms and Complications
Classification of Asthma