Horne B, Gilleece M, Jackson G, Snowden J A, Liebersbach S, Velikova G, Wright P
Psychosocial Oncology and Clinical Practice Research Group, St. James's Institute of Oncology, St. James's University Hospital, Leeds, UK.
Eur J Cancer Care (Engl). 2014 May;23(3):349-62. doi: 10.1111/ecc.12160. Epub 2013 Dec 11.
Following haematopoietic stem cell transplant (HSCT) some patients experience long-term physical and psychosocial problems which impact on everyday life. The aim of this service evaluation was to investigate the psychosocial supportive care available for HSCT patients in three UK centres, particularly related to five identified areas of concern: fatigue; psychological distress; vocational and financial issues; sexuality, and fertility. HSCT health professionals were invited to audio-recorded semi-structured interviews. Enquiry was made into supportive care provided routinely (proactive), provided in response to a need (reactive) and missing (gaps in service) from pre-transplant to 18 months post transplant. Information gathered was transcribed and subjected to framework analysis. Interviews were conducted with 84 staff including nurses, doctors, psychologists, social workers, physiotherapists, dieticians and occupational therapists. Support for the five main areas of concern was variable across centres particularly with limitation of services for psychology; sexual dysfunction and fertility. Pro-active interventions such as psychological screening were rare with support being more commonly provided in response to an identified need. Support provided reactively for the areas of concern was comprehensive across professional groups and centres. Further work explores patients' psychosocial issues and other ways of providing adjuvant support.
造血干细胞移植（HSCT）后，一些患者会出现影响日常生活的长期身体和心理社会问题。这项服务评估的目的是调查英国三个中心为HSCT患者提供的心理社会支持性护理，特别是与五个确定的关注领域相关的护理：疲劳；心理困扰；职业和财务问题；性方面以及生育能力。邀请了HSCT健康专业人员参加半结构化访谈的录音。调查了从移植前到移植后18个月常规提供的（主动的）、因需求而提供的（反应性的）以及缺失的（服务差距）支持性护理。收集到的信息被转录并进行框架分析。对84名工作人员进行了访谈，包括护士、医生、心理学家、社会工作者、物理治疗师、营养师和职业治疗师。各中心对五个主要关注领域的支持情况各不相同，尤其是在心理服务、性功能障碍和生育能力方面存在限制。诸如心理筛查等主动干预措施很少见，支持更多是在确定需求后提供。各专业群体和中心针对关注领域提供的反应性支持较为全面。进一步的工作将探索患者的心理社会问题以及提供辅助支持的其他方式。
