癌症治疗中的优质护理视角：文献综述
Perspectives of quality care in cancer treatment: a review of the literature.
作者信息
Hess Lisa M, Pohl Gerhardt
机构信息
Dr Hess is Principal Research Scientist, US Health Outcomes and Health Technology Assessment, Eli Lilly and Company, Indianapolis, IN, and Adjunct Professor, Schools of Medicine and Public Health, Indiana University, Indianapolis.
Dr Pohl is Research Advisor, Statistics, Global Patient Outcomes and Real World Evidence, Eli Lilly and Company, Indianapolis, IN.
出版信息
Am Health Drug Benefits. 2013 Jul;6(6):321-9.
BACKGROUND
Approximately 1.7 million Americans are diagnosed with cancer annually. There is an increasing demand for high-quality cancer care; however, what constitutes quality care is not well defined. There remains a gap in our knowledge regarding the current perceptions of what defines quality care.
OBJECTIVE
To review the current understanding and perspectives of key stakeholders regarding quality cancer care for adult patients with cancer who are receiving chemotherapy-based treatment regimens.
METHODS
This systematic qualitative literature review involved a search of MEDLINE and PubMed databases for articles that were published between January 2009 and May 2013 using a predefined search strategy with specific Medical Subject Headings terms encompassing 3 core concepts-cancer, chemotherapy, and quality of healthcare. Articles were eligible to be included if they focused on adult cancers, discussed quality indicators of cancer care or quality of care in the article's body, discussed treating cancer with chemotherapy, were conducted in the United States and with US respondents, and reported data about cancer quality that were obtained directly from stakeholders (eg, patients, caregivers, providers, payers, other healthcare professionals). Thematic analyses were conducted to assess the perspectives and the intersection of quality care issues from each stakeholder group that was identified, including patients, providers, and thought leaders.
RESULTS
The search strategy identified 542 articles that were reviewed for eligibility. Of these articles, 15 were eligible for inclusion in the study and reported perspectives from a total of 4934 participants. Patients with cancer, as well as providers, noted information needs, psychosocial support, responsibility for care, and coordination of care as important aspects of quality care. Providers also reported the importance of equity in cancer care and reimbursement concerns, whereas patients with cancer considered the timeliness of care an important factor. The perspectives of thought leaders focused on barriers to and facilitators of quality care.
CONCLUSION
Thematic elements related to cancer quality were relatively consistent between patients and providers; no additional information was found regarding payer perspectives. The perspectives of these groups are important to consider as quality initiatives are being developed.
背景
每年约有170万美国人被诊断患有癌症。对高质量癌症护理的需求日益增加；然而，高质量护理的构成尚未明确界定。我们对于目前对高质量护理定义的看法仍存在知识差距。
目的
回顾关键利益相关者对接受基于化疗治疗方案的成年癌症患者高质量癌症护理的当前理解和观点。
方法
这项系统性定性文献综述涉及使用预定义的检索策略，在MEDLINE和PubMed数据库中检索2009年1月至2013年5月发表的文章，使用特定医学主题词涵盖3个核心概念——癌症、化疗和医疗保健质量。如果文章关注成人癌症、在文章正文中讨论癌症护理的质量指标或护理质量、讨论用化疗治疗癌症、在美国进行且有美国受访者、并报告直接从利益相关者（如患者、护理人员、提供者、付款人、其他医疗专业人员）获得的癌症质量数据，则有资格纳入。进行主题分析以评估每个已识别的利益相关者群体（包括患者、提供者和思想领袖）对质量护理问题的观点及其交集。
结果
检索策略识别出542篇文章进行资格审查。其中，15篇符合纳入研究的条件，并报告了总共4934名参与者的观点。癌症患者以及提供者指出，信息需求、心理社会支持、护理责任和护理协调是高质量护理的重要方面。提供者还报告了癌症护理公平性和报销问题的重要性，而癌症患者则认为护理的及时性是一个重要因素。思想领袖的观点集中在高质量护理的障碍和促进因素上。
结论
患者和提供者之间与癌症质量相关的主题要素相对一致；未找到关于付款人观点的其他信息。在制定质量倡议时，考虑这些群体的观点很重要。
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