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Table 3 Summary of results pertaining to the experience of development and use of the QPSS

From: Design and introduction of a quality of life assessment and practice support system: perspectives from palliative care settings

User group Themes and corresponding codes
Clinician Desirable features for development (Stage I)
Ease of use and accessibility of the tablet technology (e.g., accessible storage, long battery life, long plug in cord, accessibility, quality of wireless networks)
Programming that provides visual accessibility (adjustable text size), appropriate language level, and cultural sensitivity (multiple language options)
Program flexibility for use in clinical care (e.g., brief assessment, skipping questions, automatic saving of progress, capacity to enter free text details)
Giving patient and family caregiver control over use of technology (e.g., online interface)
Technology context in use (Stage II)
Easy to use technology that was predominantly preferable to paper-based assessments
Concern regarding tablet theft (did not occur)
Issues with dependability of hospital and home WIFI networks
Issues with availability of power outlets in the homes
Downtime during cycles of upgrades in development impacting integration of use into regular practice
Accessibility of results at the point of care (e.g., interface with electronic medical records, printable results to paper chart, communication with other health agencies, graphing of results to observe trends, tracking of treatments)
Point of care context in use (Stage II)
Clinician beliefs regarding QPSS limiting its use (e.g., that an older population would not feel comfortable with technology, that technology would negatively impact relational care, that use of QPSS would impose a burden on patients and family caregivers)
Clinician perception that the QPSS could contribute to more complete assessments or reveal hidden concerns
Challenge of determining the clinical truth value of numerical scores in the context of high acuity and fluctuating symptoms
Perceptions of limited clinical follow-up after the use of any standardized assessment instrument
Better experience when the QPSS is used regularly in order to view trends
Health organization context in use (Stage II)
Standardized assessments seen as more suited to research than clinical practice
QPSS perceived to interfere with the use of clinician intuition and clinical judgment
Busyness and higher acuity in workload creating challenges to integration of QPSS into workflow
QPSS perceived as administrative surveillance
Change-fatigue linked to introduction of another new care initiative
Patient and Family Caregiver Experiences from stage II
Ambivalence using standardized instruments (e.g., concerns of question clarity, recall and truthfulness of responses, and meaning of scores, desired option to enter free text to clarify selected responses)
Ambivalence using technology (e.g., privacy of information)
Desired control over the use of technology (e.g., speed of completion, online interface, summary sheet of results to keep for consultation or records)
QPSS viewed mainly as a data collection tool rather than a tool that could inform their care
QPSS perceived to help elucidate areas of concern for care
Fatigue and opiate driven changes in alertness may impact use of QPSSa
QPSS might allow normalization of caregiver areas of concern or underline issues not often discussed (e.g., spiritual or existential concerns) b
  1. a Described by patients only
  2. b Described by family caregivers only