Use of a symptom diary during chemotherapy: A mixed-methods evaluation of the patient perspective.

PURPOSE/OBJECTIVES: Patients' perceptions about tools for self-reporting symptoms experienced at home may influence both the patients' use of the tool and ultimately the efficacy of the interventions. The aim of this study was to determine the extent patients use a paper-pencil symptom-monitoring diary during chemotherapy treatment, to identify factors that mediate its use at home, and to determine perceptions patients have of the diary. METHODS: A quantitative survey assessed patients' use of the diary, their experiences and opinions. A secondary analysis of semi-structured interviews used was performed to determine how patients perceived being offered the diary for tracking symptoms and, if they did use it, their experiences with the diary. RESULTS: Eighty-seven patients (78%) used or had been using the diary during their chemotherapy treatment. Most patients felt that the diary supported them in discussing treatment-related symptoms with their doctors and nurses during hospital visits and helped them to deal with symptoms at home. However, diary users felt that their professional caregivers viewed the diary differently, specifically not valuing it enough to actively use it in their care. CONCLUSIONS: This study indicates that the majority of chemotherapy patients at our hospital perceive the symptom diary to be a feasible tool in terms of ease of use and time investment and that it is helpful. However, from the patient perspective, healthcare professionals' implementation of the diary in their behalf is lacking.

Implementation and Use of a Patient Symptom Diary During Chemotherapy: A Mixed-Methods Evaluation of the Nurse Perspective.

PURPOSE/OBJECTIVES: To gain a deeper understanding of nurses' experience working with a patient diary for tracking and treating side effects during chemotherapy.
. DESIGN: A mixed-methods design was used to learn about oncology nurses' use and perceptions of a symptom diary. 
. SETTING: Six oncology wards and two outpatient clinics at the University Hospitals Leuven, Belgium.
. SAMPLE: 79 nurses completed a survey, and 14 nurses participated in focus group discussions.
. METHODS: First, a survey sampled nurses' use and perceptions of the diary. Next, focus group discussions were held with the aim of arriving at a deeper understanding of the survey results.
. MAIN RESEARCH VARIABLES: Use and perceptions of a symptom diary.
. FINDINGS: Most nurses reported performing diary-related behavior to some extent. The survey and focus groups indicated that many nurses strongly believed in the value of the diary, but some were still hesitant or had concerns about patients' perceptions of the diary. The focus group results showed that nurses' use of the diary in daily practice was influenced by their personal beliefs about the value of the diary, the team's, and those of their patients.
. CONCLUSIONS: Although a positive trend was noted, nurses' use of the symptom diary was suboptimal six months after its implementation.
. IMPLICATIONS FOR NURSING: This study highlights important issues that need to be addressed to advance the successful implementation of the symptom diary.