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一项针对医疗保健专业人员的横断面调查,旨在确定他们认为什么是青少年和年轻成年癌症患者的“专科”护理。

A cross-sectional survey of healthcare professionals to determine what they believe constitutes 'specialist' care for teenage and young adult patients with cancer.

机构信息

Paediatric Epidemiology Group, University of Leeds, Leeds, UK.

出版信息

BMJ Open. 2013 May 2;3(5):e002346. doi: 10.1136/bmjopen-2012-002346.

Abstract

OBJECTIVES

To examine the attitudes of UK healthcare professionals towards what they believe constitutes specialist care for teenage and young adult (TYA) patients with cancer, to determine which factors they considered to be the most important components of specialist TYA care, and whether opinion varied between clinical specialties and reflected the drivers for care improvements within National Health Service (NHS) policy.

DESIGN AND METHODS

The study utilised a cross-sectional survey, using Likert scales, to assess attitudes towards specialist care. Responses were grouped using model-based clustering methods implemented in LatentGold 4.5.

SETTING

Participants from 98 NHS trusts in the UK were invited to participate in the study.

PARTICIPANTS

691 healthcare professionals involved in the management of TYA patients were approached; of these, 338 responded.

RESULTS

338 healthcare professionals responded (51.9% of those invited). Responses were grouped into three clusters according to the pattern of responses to the questions. One cluster rated age-appropriate care above all else, the second rated both age and site-appropriate care highly while the third assigned more importance to site-specific care. Overall, the psychosocial and supportive aspects of care were rated highest while statements relating to factors known to be important (access to clinical trials, treatment at a high volume centre and specialist diagnostics) were not rated as highly as expected.

CONCLUSIONS

Attitudes varied widely between professionals treating TYA patients with cancer as to what constitutes key aspects of specialist care. Further work is needed to quantify the extent to which this influences practice.

摘要

目的

调查英国医疗保健专业人员对他们认为构成青少年和年轻成人(TYA)癌症患者专科护理的看法,确定他们认为专科 TYA 护理最重要的组成部分有哪些,以及不同临床专业之间的观点是否存在差异,并反映出英国国家医疗服务体系(NHS)政策中改善护理的驱动力。

设计与方法

本研究采用横断面调查,使用李克特量表评估对专科护理的态度。使用 LatentGold 4.5 中实施的基于模型的聚类方法对响应进行分组。

设置

邀请来自英国 98 家 NHS 信托的参与者参加研究。

参与者

接触 TYA 患者管理的 691 名医疗保健专业人员被邀请参与研究;其中 338 名做出了回应。

结果

338 名医疗保健专业人员做出了回应(邀请人数的 51.9%)。根据对问题的回答模式,将响应分为三个聚类。一个聚类将适合年龄的护理评为最重要的,第二个聚类将年龄和部位适当的护理都评为高度重要,第三个聚类则更重视部位特定的护理。总体而言,护理的心理社会和支持方面的评价最高,而与已知重要因素(临床试验的参与、在高容量中心治疗和专科诊断)相关的陈述的评价则不如预期的高。

结论

治疗 TYA 癌症患者的专业人员对专科护理的关键方面的看法差异很大。需要进一步的工作来量化这在多大程度上影响实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c713/3646178/21c022608ee6/bmjopen2012002346f01.jpg

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