Tan E L, Stark H, Lowinger J S, Ringland C, Ward R, Pearson S -A
Population Health and Use of Medicines Unit, St Vincent's Hospital, Sydney, NSW, Australia.
Intern Med J. 2006 Nov;36(11):711-7. doi: 10.1111/j.1445-5994.2006.01171.x.
This study identified (i) information sources used by cancer clinicians to guide pharmacological treatments, (ii) utilization of, and opinions about, online information sources and (iii) clinicians' ability to access a specific cancer treatment protocol (escalated bleomycin, etiposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone (BEACOPP) for Hodgkin's Lymphoma). The work was carried out before activation of the Cancer Institute New South Wales Standard Cancer Treatment (CI-SCaT) programme.
We conducted semistructured interviews with a purposeful sample of senior and junior doctors, nurses and pharmacists treating adult cancer patients (n = 32) in eight New South Wales public hospitals.
Information seeking processes are context specific and vary from clinician to clinician and ward to ward. Clinicians use human, electronic and printed information sources at, or close to, the point of patient care; however, experienced colleagues are preferred where information is needed quickly or in unfamiliar clinical situations. Barriers to using online cancer information are environmental (hardware, connection speeds, time), personal (poor computer literacy and lack of awareness of appropriate sites) and economic (costs of journal subscriptions). Just over half of participants were able to locate a specific cancer protocol and none of these protocols was fully consistent with CI-SCaT recommendations.
There is no standardized approach to the pharmacological treatment of cancer patients in this sample of New South Wales clinicians. CI-SCaT will fill a gap with respect to standardizing oncology treatment. However, to ensure maximal CI-SCaT uptake, implementation plans should harness positive behavioural influences and attempt to modify the negative forces that act on hospital clinicians in their day-to-day work.
本研究确定了（i）癌症临床医生用于指导药物治疗的信息来源，（ii）对在线信息来源的利用情况和看法，以及（iii）临床医生获取特定癌症治疗方案（用于霍奇金淋巴瘤的强化博来霉素、依托泊苷、阿霉素、环磷酰胺、长春新碱、丙卡巴肼、泼尼松（BEACOPP））的能力。这项工作是在新南威尔士州癌症研究所标准癌症治疗（CI-SCaT）计划启动之前开展的。
我们对新南威尔士州八家公立医院中治疗成年癌症患者的高级和初级医生、护士及药剂师进行了有目的抽样的半结构化访谈（n = 32）。
信息搜索过程因具体情况而异，临床医生之间以及病房之间各不相同。临床医生在患者护理点或接近护理点的地方使用人力、电子和印刷信息来源；然而，在需要快速获取信息或遇到不熟悉的临床情况时，经验丰富的同事更受青睐。使用在线癌症信息的障碍包括环境因素（硬件、连接速度、时间）、个人因素（计算机知识匮乏以及对合适网站缺乏了解）和经济因素（期刊订阅费用）。略多于一半的参与者能够找到特定的癌症治疗方案，但这些方案均未完全符合CI-SCaT的建议。
在新南威尔士州临床医生的这个样本中，对于癌症患者的药物治疗没有标准化的方法。CI-SCaT将填补肿瘤治疗标准化方面的空白。然而，为确保最大程度地采用CI-SCaT，实施计划应利用积极的行为影响，并尝试改变在日常工作中作用于医院临床医生的消极因素。
