Tom Baker Cancer Centre; Cancer Care, Alberta Health Services; and Department of Oncology, University of Calgary, Calgary, AB.
Curr Oncol. 2011 Jun;18(3):e137-49. doi: 10.3747/co.v18i3.741.
Distributed delivery models for cancer care have been introduced to bring care closer to home and to provide better access to cancer patients needing radiotherapy. Very little work has been done to demonstrate the elements critical for success in a non-centralized approach. The present study set out to identify the elements that are important for implementing radiotherapy away from large cities.
This qualitative research project consisted of two separate components. In the first component, structured interviews were conducted with 5 external experts. Input on the expert responses was then sought from internal leaders in medical physics, radiation therapy, and radiation oncology. Those interviews were used to develop a proposed template of the elements needed in a small-city department. We tested the validity of all elements by surveying staff members from the radiation treatment program in Calgary, leading to a definition of the resources needed for the proposed department in Lethbridge. Seventy-five staff members contributed to the survey.
Qualitative research methods allowed us to define important elements for a small-city radiotherapy department and to validate those elements with a large cohort of staff working in a tertiary centre. This work has influenced the planning of a small-city department in Lethbridge, emphasizing the importance of the elements identified to the service planners. We await the completion of the construction project and the opening of the centre so that we can re-evaluate the importance of the identified elements in actual practice. We recommend such an approach to jurisdictions that are considering devolved radiotherapy.
为了使癌症护理更贴近家庭，并为需要放疗的癌症患者提供更好的治疗机会，已经引入了分布式癌症护理交付模式。然而，在非集中化方法中，对于取得成功至关重要的因素，目前仅有很少的工作得以开展。本研究旨在确定在远离大城市的地方实施放疗的重要因素。
本定性研究项目由两个独立的部分组成。在第一部分中，对 5 名外部专家进行了结构化访谈。然后，向医学物理学、放射治疗和放射肿瘤学领域的内部领导者寻求对专家回复的意见。这些访谈被用来制定一个小市部门所需要素的建议模板。我们通过对卡尔加里放射治疗项目的工作人员进行调查，测试了所有要素的有效性，从而为莱斯布里奇拟议部门确定了所需资源。共有 75 名工作人员参与了调查。
定性研究方法使我们能够确定小城市放射治疗部门的重要因素，并通过在三级中心工作的大量员工对这些因素进行验证。这项工作影响了莱斯布里奇小城市部门的规划，强调了对服务规划者具有重要意义的要素。我们正在等待建设项目的完成和中心的开放，以便我们能够重新评估实际实践中确定要素的重要性。我们建议考虑分散放疗的司法管辖区采用这种方法。
