Spencer L, Battye L
New Perspectives, Bealings Barn, Grundisburgh Road, Great Bealings, Woodbridge, Suffolk, IP13 6PE, UK.
Eur J Oncol Nurs. 2001 Sep;5(3):190-7. doi: 10.1054/ejon.2001.0147.
In-depth interviews and discussions were held with 40 different professionals in South East England involved in managing palliative care for children with cancer in the community. Participants included paediatric oncologists and outreach nurse specialists in tertiary centres, paediatricians in shared care units, children's community nurses, general practitioners, social workers and child psychologists. The research examined palliative care services available in the region, exploring attitudes to both current provision and possible service improvements. Providing palliative care in the community involves multi-agency collaboration and the study highlighted a range of different approaches to case management with the diversity of resources available. Key improvements proposed by health-care professionals included: better communication and liaison between all the professionals involved; clearer allocation of roles and responsibilities; 24-hour availability of specialist advice on palliative care for children with cancer; faster access to social work and psychology services at the community level; continuity of nursing and respite care. The provision of specialist local palliative care services for children with cancer was generally rejected. The participants favoured improving community palliative care for all children with life-limiting or life-threatening conditions with community nursing teams providing continuity of care and outreach nurses providing specialist advice and support.
研究人员对英格兰东南部40位参与社区中癌症患儿姑息治疗管理的不同专业人士进行了深入访谈和讨论。参与者包括三级医疗中心的儿科肿瘤学家和外展护士专家、共享护理单元的儿科医生、儿童社区护士、全科医生、社会工作者和儿童心理学家。该研究调查了该地区现有的姑息治疗服务，探讨了对当前服务提供情况以及可能的服务改进的态度。在社区提供姑息治疗需要多机构合作，该研究强调了在可用资源多样的情况下，一系列不同的病例管理方法。医疗保健专业人员提出的主要改进建议包括：所有相关专业人员之间加强沟通与联络；更明确地分配角色和职责；为癌症患儿提供24小时的姑息治疗专家咨询；在社区层面更快获得社会工作和心理服务；护理和临时护理的连续性。为癌症患儿提供专门的当地姑息治疗服务的提议普遍遭到否决。参与者赞成改善对所有患有危及生命或有生命危险疾病的儿童的社区姑息治疗，由社区护理团队提供持续护理，外展护士提供专家咨询和支持。
