Background: Monitoring adverse Events (AEs) is a standard practice for clinician to assess the overall effect of anti-cancer treatment on patients. However, studies have found clinicians have difficulty in capturing nuance aspects of patient-centered AEs. We aimed to explore the differences between nurses and clinicians in term of subjective AEs assessment and discuss the nurses’ role in subjective AEs assessment.
Methods: From April and July, 2020, a questionnaires based study was conducted in Day Chemotherapy ward of Breast Center in Hebei Cancer Hospital. Six common subjective AEs were assessed by nurses and clinicians utilizing Common Terminology Criteria for Adverse Events (CTCAE). Patients needed to self-report their own subject AEs by filling up a Simplified Chinese version of PRO-CTCAE containing the same AEs. Results from the three different pairs (Nurse/Patient, Nurse/ Clinician, and Clinician/Patient) were collected and analyzed. Chi-square test and kappa coefficient were utilized to analysis the differences and consistency among different pairs.
Results: of 417 patients were asked to participate in the study, 384 pairs surveys were collected. Nurses detected more AEs than clinicians, and the differences were statistically significant (P＜0.00). Nurse/patient pair scored the highest agreement in terms of reporting rate and toxicity grade for most of AEs except the toxicity grade for the frequency of vomiting and pain which were as consistent as nurse/clinician.
Conclusions: The results of this study support nurses can be successfully enrolled in the assessment of subjective AEs because of the greater ability to elicit more patient-centered information than clinicians.