Neurosurgical nurses’ perspectives of patient-reported outcomes: a qualitative study

Patient-reported outcomes (PROs) are critical in neurosurgical care for addressing post-discharge unmet needs (e.g., pain, functional impairments), yet traditional assessment models often neglect subjective experiences. Although PROs integrate patient perspectives with clinical indicators, improving diagnosis and care, significant variations exist in nurses’ understanding of PROs, potentially hindering implementation. This study explores neurosurgical nurses’ perspectives and experiences to inform a Nurse-led PROs System. Using purposive sampling, 15 neurosurgical nurses from two institutions participated in offline semi-structured interviews between December 2024 and January 2025. Interviews (30–60 minutes) explored PROs awareness, barriers, and application in practice. Data were transcribed verbatim and analyzed via the Kawakita Jiro (KJ) method to identify thematic patterns. Ethical approval was obtained (Lun Audit [2024] 222). Thematic saturation was reached after 15 interviews.The study identified six themes: (1) Prevailing challenges; (2) Cognitive level; (3) Patients’ medical experience; (4) Impact factors; (5) System support; (6) The ‘Shared decision-making discharge’ Model. To address PROs implementation gaps, senior management must prioritize nurse training, digital infrastructure, and multidisciplinary collaboration. A Nurse-led PROs System should standardize post-discharge assessments, while the proposed “Shared Decision-Making Discharge” model could bridge patient-provider communication gaps. Future studies should test this model’s impact on care quality. Not applicable. (1) In our study, some neurosurgical nurses demonstrated limited awareness of PROs (e.g., 12/15 interviewees conflated PROs with routine symptom checks). Combined with patients’ socio-economic barriers (e.g., low health literacy), these gaps may contribute to suboptimal post-discharge communication and unmet care needs. (2) Based on nurses’ input, we proposed a PROs integration framework for neurosurgical nursing, emphasizing standardized assessment tools and nurse-led discharge planning. Pilot testing is needed to evaluate its potential to enhance care quality and patient experience. (3) We developed the ‘Shared Decision-Making Discharge Model’ (SDM-D), incorporating PROs into multidisciplinary discharge planning. Most of interviewed nurses endorsed SDM-D as a strategy to balance stakeholder inputs and formalize nurses’ advocacy role in care transitions.