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肺癌患者与晚期慢性阻塞性肺疾病患者临终关怀的协调:是否有可借鉴的经验?一项纵向定性研究。

Coordination of end-of-life care for patients with lung cancer and those with advanced COPD: are there transferable lessons? A longitudinal qualitative study.

作者信息

Epiphaniou Eleni, Shipman Cathy, Harding Richard, Mason Bruce, Murray Scott A A, Higginson Irene J, Daveson Barbara A

机构信息

Department of Palliative Care Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, UK.

出版信息

Prim Care Respir J. 2014 Mar;23(1):46-51. doi: 10.4104/pcrj.2014.00004.

Abstract

BACKGROUND

Care coordination is defined as good communication between professionals to enable access to services based on need.

AIMS

To explore patients' experience of care coordination in order to inform current debates on how best to coordinate care and deliver services in end-of-life for patients with lung cancer and those with chronic obstructive pulmonary disease (COPD).

METHODS

A qualitative study involving serial interviews was performed in 18 patients recruited from three hospital outpatient clinics situated in a hospital. Interviews were transcribed verbatim and data were analysed thematically.

RESULTS

Data comprised 38 interviews. Patients experiencing services related to lung cancer reported good access enabled by the involvement of a keyworker. This contrasted with COPD patients' experiences of services. The keyworker coordinated care between and within clinical settings, referred patients to community palliative care services, helped them with financial issues, and provided support.

CONCLUSIONS

For patients with lung cancer, the keyworker's role augmented access to various services and enabled care based on their needs. The experiences of patients with COPD highlight the importance of providing a keyworker for this group of patients in both secondary and primary care.

摘要

背景

护理协调被定义为专业人员之间良好的沟通,以便根据需求获得服务。

目的

探讨患者对护理协调的体验,为当前关于如何在肺癌患者和慢性阻塞性肺疾病(COPD)患者的临终阶段以最佳方式协调护理和提供服务的辩论提供信息。

方法

对从一家医院的三个医院门诊诊所招募的18名患者进行了一项涉及系列访谈的定性研究。访谈逐字记录,数据进行主题分析。

结果

数据包括38次访谈。经历肺癌相关服务的患者报告称,由于一名关键工作人员的参与,他们能够很好地获得服务。这与慢性阻塞性肺疾病患者的服务体验形成对比。关键工作人员在临床环境之间和内部协调护理,将患者转介至社区姑息治疗服务,帮助他们解决财务问题,并提供支持。

结论

对于肺癌患者,关键工作人员的角色增加了获得各种服务的机会,并根据他们的需求提供护理。慢性阻塞性肺疾病患者的经历凸显了在二级和初级护理中为这组患者配备关键工作人员的重要性。

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