定性研究：一种在癌症临床试验中验证患者对姑息治疗看法的验证方法。
Qualitative inquiry: a method for validating patient perceptions of palliative care while enrolled on a cancer clinical trial.
机构信息
Department of Medical Ethics and Health Policy, New Courtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, USA.
National Institutes of Health Clinical Center, 10 Center Drive, 2B-09, Bethesda, MD 20892, USA.
出版信息
BMC Palliat Care. 2014 Sep 5;13:43. doi: 10.1186/1472-684X-13-43. eCollection 2014.
BACKGROUND
Palliative care is a vital component of patient-centered care. It has increasingly become central to the management and care of seriously ill patients by integrating physical, psychosocial, and spiritual supportive services. Through qualitative inquiry, this paper examines cancer patients' perceptions of the process and outcomes of the pain and palliative care consultative services they received while enrolled in a clinical trial.
METHODS
A qualitative analysis of open-ended questions was conducted from a sub-sample of patients (n = 34) with advanced cancers enrolled in a randomized controlled trial exploring the efficacy of a palliative care consult service. Two open-ended questions focused on patient perceptions of continued participation on their primary cancer clinical trials and their perceptions of interdisciplinary communication.
RESULTS
THREE OVERARCHING THEMES EMERGED WHEN ASKED WHETHER RECEIVING PAIN AND PALLIATIVE CARE SERVICES MADE THEM MORE LIKELY TO REMAIN ENROLLED IN THEIR PRIMARY CANCER CLINICAL TRIAL: patients' past experiences with care, self-identified personal characteristics and reasons for participation, and the quality of the partnership. Four themes emerged related to interdisciplinary communication including: the importance of developing relationships, facilitating open communication, having quality communication, and uncertainty about communication between the cancer clinical trial and palliative care teams.
CONCLUSIONS
Our findings suggest the importance of qualitative inquiry methods to explore patient perceptions regarding the efficacy of palliative care services for cancer patients enrolled in a cancer clinical trial. Validation of patient perceptions through qualitative inquiry regarding their pain and palliative care needs can provide insight into areas for future implementation research.
TRIAL REGISTRATION
NIH Office of Human Subjects Research Protection OHSRP5443 and University of Pennsylvania 813365.
背景
姑息治疗是患者为中心的护理的重要组成部分。通过整合身体、心理社会和精神支持服务，姑息治疗越来越成为重病患者管理和护理的核心。本文通过定性研究，考察了癌症患者对参加临床试验时接受的疼痛和姑息治疗咨询服务的过程和结果的看法。
方法
对参加探索姑息治疗咨询服务疗效的随机对照试验的晚期癌症患者（n=34）的亚样本进行了开放式问题的定性分析。两个开放式问题集中在患者对继续参加主要癌症临床试验的看法以及对跨学科交流的看法。
结果
当被问及接受疼痛和姑息治疗服务是否更有可能让他们继续参加主要癌症临床试验时，出现了三个总体主题：患者过去的护理经历、自我认同的个人特征和参与原因，以及合作关系的质量。与跨学科交流相关的四个主题包括：建立关系的重要性、促进开放沟通、进行高质量的沟通以及对癌症临床试验和姑息治疗团队之间沟通的不确定性。
结论
我们的研究结果表明，定性研究方法对于探索癌症患者对参加癌症临床试验的姑息治疗服务的疗效的看法非常重要。通过定性研究验证患者对疼痛和姑息治疗需求的看法，可以为未来的实施研究提供深入了解。
试验注册
NIH 人类受试者研究保护办公室 OHSRP5443 和宾夕法尼亚大学 813365。
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