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初级保健临床医生与癌症幸存者及其肿瘤医生之间的信息共享经验。

The experience of information sharing among primary care clinicians with cancer survivors and their oncologists.

机构信息

Department of Nursing, Lehman College, Bronx, NY 10468, USA.

出版信息

J Cancer Surviv. 2013 Mar;7(1):124-30. doi: 10.1007/s11764-012-0253-7. Epub 2012 Nov 27.

Abstract

PURPOSE OF STUDY

Knowledge about information sharing among primary care clinicians, oncologists, and their cancer patients is critical given its importance in facilitating the delivery of quality care to the increasing number of cancer survivors. The purpose of our study was to provide a better understanding of the nature of interactions among primary care clinicians, patients, and oncologists throughout the cancer care continuum to better understand the transition to survivorship.

METHOD

Twenty-one qualitative in-depth interviews were conducted with 11 primary care physicians and 10 nurse practitioners. Themes were identified using content analysis.

RESULTS

The following themes emerged from the data including: (1) a visit is worth a thousand written reports--primary care clinicians described the importance of patient visits during cancer treatment; (2) community vs. cancer center oncologists--primary care clinicians described differences in information sharing with community oncologists as compared with those in academic centers; (3) correcting for information deficits--primary care clinicians, unable to obtain regular progress reports directly from oncologists, developed indirect strategies to obtain information; (4) the deficiencies in post-treatment follow-up care plans; and (5) the panacea of electronic medical records and survivor care plans.

CONCLUSIONS

The themes that emerged from this work describe in detail the absence of systematic information sharing among primary care clinicians, patients, and oncologists that is needed to support quality survivorship care in the primary care setting. The descriptions by primary care clinicians contribute to a deeper understanding of the daily challenges that both interfere and/or support primary care clinicians in their care of survivors of cancer.

IMPLICATIONS FOR CANCER SURVIVORS

Managing the complex care of cancer survivors often requires the expertise of a number of skilled providers. Information sharing among these individuals is one of the most fundamental aspects of ensuring effective transitions in care. Our results indicate that systematic information sharing among providers caring for cancer survivors is lacking. Identifying strategies to enhance information sharing among and between providers is essential to facilitating the delivery of high-quality survivor care.

摘要

研究目的

鉴于信息共享在为越来越多的癌症幸存者提供优质护理方面的重要性,了解初级保健临床医生、肿瘤医生及其癌症患者之间的信息共享情况至关重要。我们研究的目的是更好地了解初级保健临床医生、患者和肿瘤医生在整个癌症护理过程中的相互作用性质,以便更好地了解向生存者过渡的情况。

研究方法

对 11 名初级保健医生和 10 名执业护士进行了 21 次定性深入访谈。使用内容分析法确定主题。

研究结果

数据中出现了以下主题,包括:(1)一次就诊抵得上一千份书面报告——初级保健临床医生描述了在癌症治疗期间患者就诊的重要性;(2)社区与癌症中心肿瘤医生——初级保健临床医生描述了与社区肿瘤医生相比,与学术中心肿瘤医生分享信息的差异;(3)纠正信息缺陷——初级保健临床医生无法直接从肿瘤医生那里获得定期进展报告,因此制定了间接获取信息的策略;(4)治疗后随访护理计划的缺陷;以及(5)电子病历和生存者护理计划的万灵药。

研究结论

这项工作中出现的主题详细描述了初级保健临床医生、患者和肿瘤医生之间缺乏系统的信息共享,这是在初级保健环境中支持高质量生存者护理所必需的。初级保健临床医生的描述有助于更深入地了解日常挑战,这些挑战既干扰又/或支持初级保健临床医生对癌症幸存者的护理。

对癌症幸存者的影响

管理癌症幸存者的复杂护理通常需要许多熟练提供者的专业知识。这些人之间的信息共享是确保护理有效过渡的最基本方面之一。我们的研究结果表明,照顾癌症幸存者的提供者之间系统的信息共享是缺乏的。确定加强提供者之间和提供者内部信息共享的策略对于促进高质量生存者护理的提供至关重要。

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