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Paper short abstract

PROMs are widely promoted in healthcare, yet their clinical use remains unsettled. Attending to the collectiveness of PROM responses, this paper shows how data collection produces epistemic double vision as nurses navigate tensions between standardized data production and situated care.

Paper long abstract

While patient-reported outcomes (PROMs) are promoted as instruments for patient-centred and efficient healthcare, their integration into practice remains in its early stages. Moreover, the production of PROM data is suspended between the present, where accurate responses are generated, and the future, where data is expected to improve care for both individuals and the collective. In dialogue with the panel’s interest in participatory surveillance, this paper examines how PROM-collection intertwines with nursing practice. Existing research shows that PROM-collection requires sustained effort from professionals, yet less attention has been paid to how this work is managed practically and affectively.

Drawing on empirical data from clinical encounters between lung cancer patients and nurses assisting them with PROM questionnaires, we show how this data work gives rise to what we term epistemic double vision. Inspired by McClimans’ depiction of contemporary medicine as Janus-faced, the concept captures how nurses orient toward two epistemic demands: a future turned data optic emphasizing objectivity and decontextualized responses, and a situated care optic requiring interpretive engagement with patients in the present. Nurses attempt to rely on the data optic to produce “clean” data, yet their situated care optic repeatedly blurs this orientation, prompting interpretation and adjustment. This makes PROM-collection feel disruptive, though nurses also note that PROMs can deepen dialogue with patients. Attending to the collective dimension of data production reveals that producing healthcare data is a distinct form of care work that shapes data and raises questions about how new data practices are woven into existing routines.