Surgical Outcomes Research Centre, School of Public Health, University of Sydney and Sydney South West Area Health Service, NSW Australia.
BMC Health Serv Res. 2010 May 20;10:132. doi: 10.1186/1472-6963-10-132.
National cancer policies identify the improvement of care coordination as a priority to improve the delivery of health services for people with cancer. Identification of the current barriers to effective cancer care coordination is needed to drive service improvement.
A qualitative study was undertaken in which semi-structured individual interviews and focus groups were conducted with those best placed to identify issues; patients who had been treated for a range of cancers and their carers as well as health professionals involved in providing cancer care. Data collection continued until saturation of concepts was reached. A grounded theory influenced approach was used to explore the participants' experiences and views of cancer care coordination.
Overall, 20 patients, four carers and 29 health professionals participated. Barriers to cancer care coordination related to six aspects of care namely, recognising health professional roles and responsibilities, implementing comprehensive multidisciplinary team meetings, transitioning of care: falling through the cracks, inadequate communication between specialist and primary care, inequitable access to health services and managing scarce resources.
This study has identified a number of barriers to coordination of cancer care. Development and evaluation of interventions based on these findings is now required.
国家癌症政策将改善护理协调作为优先事项，以改善癌症患者的医疗服务提供。为了推动服务改善，需要确定有效癌症护理协调的当前障碍。
进行了一项定性研究，对最有能力识别问题的人员进行了半结构化的个人访谈和焦点小组讨论；包括接受过各种癌症治疗的患者及其照顾者以及参与癌症护理的卫生专业人员。数据收集持续到概念达到饱和为止。采用扎根理论影响方法来探讨参与者对癌症护理协调的经验和看法。
共有 20 名患者、4 名照顾者和 29 名卫生专业人员参与了研究。癌症护理协调的障碍涉及护理的六个方面，包括：识别卫生专业人员的角色和责任、实施综合多学科团队会议、护理交接：出现漏洞、专科医生和初级保健之间沟通不足、卫生服务获得的不公平以及资源的稀缺。
本研究确定了协调癌症护理的一些障碍。现在需要根据这些发现制定和评估干预措施。
