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结直肠癌护理中的协作与沟通:对患者和医护人员所经历挑战的定性研究

Collaboration and communication in colorectal cancer care: a qualitative study of the challenges experienced by patients and health care professionals.

作者信息

Kamradt Martina, Baudendistel Ines, Längst Gerda, Kiel Marion, Eckrich Felicitas, Winkler Eva, Szecsenyi Joachim, Ose Dominik

机构信息

Department of General Practice and Health Services Research, University Hospital Heidelberg and

Department of General Practice and Health Services Research, University Hospital Heidelberg and.

出版信息

Fam Pract. 2015 Dec;32(6):686-93. doi: 10.1093/fampra/cmv069. Epub 2015 Aug 26.

Abstract

BACKGROUND

Colorectal cancer is becoming a chronic condition. This has significant implications for the delivery of health care and implies the involvement of a range of health care professionals (HCPs) from different settings to ensure the needed quality and continuity of care.

OBJECTIVES

To explore the challenges that patients and HCPs experience in the course of colorectal cancer care and the perceived consequences caused by these challenges.

METHODS

Ten semi-structured focus groups were conducted including patients receiving treatment for colorectal cancer, representatives of patient support groups, physicians and other non-physician HCPs from different health care settings. Participants were asked to share their experiences regarding colorectal cancer care. All data were audio- and videotaped, transcribed verbatim and thematically analysed using qualitative content analysis.

RESULTS

Patients and HCPs (total N = 47) experienced collaboration and communication as well as exchange of information between HCPs as challenging. Particularly communication and information exchange with GPs appeared to be lacking. The difficulties identified restricted a well-working coordination of care and seemed to cause inappropriate health care.

CONCLUSION

Colorectal cancer care seems to require an effective, well-working collaboration and communication between the different HCPs involved ensuring the best possible care to suit patients' individual needs. However, the perceived challenges and consequences of our participants seem to restrict the delivery of the needed quality of care. Therefore, it seems crucial (i) to include all HCPs involved, especially the GP, (ii) to support an efficient and standardized exchange of health-related information and (iii) to focus on the patients' entire pathway of care.

摘要

背景

结直肠癌正逐渐成为一种慢性病。这对医疗保健的提供具有重大影响,意味着需要不同医疗环境中的一系列医疗保健专业人员(HCPs)参与,以确保所需的护理质量和连续性。

目的

探讨患者和医疗保健专业人员在结直肠癌护理过程中所经历的挑战以及这些挑战所带来的感知后果。

方法

开展了10个半结构化焦点小组讨论,参与者包括接受结直肠癌治疗的患者、患者支持小组代表、医生以及来自不同医疗保健环境的其他非医生医疗保健专业人员。参与者被要求分享他们在结直肠癌护理方面的经历。所有数据进行了音频和视频录制,逐字转录,并使用定性内容分析法进行主题分析。

结果

患者和医疗保健专业人员(共47人)认为医疗保健专业人员之间的协作、沟通以及信息交流具有挑战性。特别是与全科医生的沟通和信息交流似乎存在不足。所发现的这些困难限制了护理工作的良好协调,似乎还导致了不适当的医疗保健。

结论

结直肠癌护理似乎需要不同医疗保健专业人员之间进行有效、良好的协作与沟通,以确保提供最适合患者个体需求的最佳护理。然而,我们参与者所感知到的挑战和后果似乎限制了所需护理质量的提供。因此,似乎至关重要的是:(i)纳入所有相关的医疗保健专业人员,尤其是全科医生;(ii)支持高效、标准化的健康相关信息交流;(iii)关注患者的整个护理路径。

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