title: Healthcare Professionals' Preferences and Perceived Barriers for Routine Assessment of Patient-Reported Outcomes in Pediatric Oncology Practice: Moving Toward International Processes of Change.
abstract: Using patient-reported outcomes (PROs) in clinical practice has been shown to enhance detection of health-related quality of life problems and satisfaction with care in children with cancer. This study seeks to identify which PRO information healthcare professionals (HCPs) find useful and what the perceived barriers for routinely assessing PROs are.
  
  
  
  A total of 352 pediatric HCPs (43% male) from 52 countries completed a semistructured online 28-item questionnaire. Descriptive statistics (percentages) were used to identify highly important PRO information and perceived barriers. HCPs' perceived barriers were compared according to gender, years of work experience, and country using a Fishers exact test.
  
  
  
  The five highest ranked PRO topics relevant in routine assessment by HCPs were as follows: pain (98%), feeling sad or depressed (96%), overall physical symptoms (95%), problems with therapy adherence (94%), and overall emotional issues (93%). Five lowest ranked topics were as follows: difficulties praying (50%), other spiritual concerns (55, 56, and 60%), and feeling bored (60%). Barriers for assessing PROs included: time (58%), insufficient staff (49%), logistics (32%), and financial resources (26%). Providers from developing countries more often reported barriers concerning insufficient staff, logistics, and financial resources.
  
  
  
  HCPs strongly value the use of physical and psychosocial PROs within pediatric oncology practice, but mainly perceive organizational barriers for routine assessment. To successfully integrate PROs, efforts should be made to address HCP-perceived barriers, such that patient-reported problems can be detected and timely referrals made.
authors: Division of Pediatrics, Psychosocial Department, Academic Medical Centre/Emma Children's Hospital, Amsterdam, the Netherlands. s.a.schepers@amc.nl.|Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands. s.a.schepers@amc.nl.
authors: Sasja A
authors: SA
authors: Schepers
authors: Division of Pediatrics, Psychosocial Department, Academic Medical Centre/Emma Children's Hospital, Amsterdam, the Netherlands.
authors: Lotte
authors: L
authors: Haverman
authors: Behavioral Health Core, Pediatric Psychosocial Support and Research Program, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland.
authors: Sima
authors: S
authors: Zadeh
authors: Division of Pediatrics, Psychosocial Department, Academic Medical Centre/Emma Children's Hospital, Amsterdam, the Netherlands.|Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
authors: Martha A
authors: MA
authors: Grootenhuis
authors: Behavioral Health Core, Pediatric Psychosocial Support and Research Program, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland.
authors: Lori
authors: L
authors: Wiener
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006282:Health Personnel; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D000071066:Patient Reported Outcome Measures
keywords: patient-reported outcomes; pediatric oncology; psychosocial; quality of life