Healthcare Professional Perspectives on Digital Health-Related Quality-of-Life Assessment in Paediatric Radiation Therapy: A Qualitative Study

Introduction: Health-related quality of life (HRQoL) is not routinely evaluated using patient-reported outcome measures (PROMs) in paediatric radiation therapy (RT). This study aimed to identify barriers and facilitators to HRQoL implementation in paediatric RT clinical practice and requirements for a digital PROM platform, from the perspectives of healthcare professionals. Method: Exploratory semi-structured interviews were conducted with multidisciplinary clinicians from two hospitals providing care to paediatric RT patients. Interviews were transcribed verbatim, descriptively coded and analysed using content analysis. Consolidated Framework for Implementation Research (CFIR) was used as a theoretical framework for data collection, analysis and interpretation. Results: Nine interviews were held with nurses (n = 3), radiation therapists (n = 3), radiation oncology registrars (n = 2) and a consultant family therapist. Participants identified digital, clinical and child-friendly features to inform platform development. All participants recognised the proposed digital platform to be of value by generating new information to support patient care. The perceived alignment with clinical workflows, potential to provide staff satisfaction and individual scope to act on PROM results were key facilitators. Clinical time pressures, transient staffing and reluctance for change were identified as potential barriers. Engagement of clinical staff and training in addressing psychosocial concerns were recommended to support clinical actioning of results and foster successful clinical uptake. Conclusion: This study used CFIR to systematically identify requirements for a digital platform and barriers to routine patient-reported HRQoL collection in the paediatric RT setting. The facilitators and complexities of PROM implementation can inform platform development and future implementation strategies.