Burridge Letitia, Mitchell Geoffrey, Jiwa Moyez, Girgis Afaf
School of Medicine, The University of Queensland, Royal Brisbane and Women's Hospitals, Herston, Queensland, Australia.
School of Medicine Sydney, Melbourne Clinical School, University of Notre Dame, Australia.
Health Soc Care Community. 2017 Mar;25(2):357-365. doi: 10.1111/hsc.12312. Epub 2015 Dec 23.
The lay caregiving role is integral to advanced cancer care but places carers' health at risk. A supportive General Practitioner (GP) can help primary lay carers manage their health, if they disclose their concerns. A Needs Assessment Tool for Caregivers (NAT-C) was developed for carers to self-complete and use as the basis of a GP consultation, then tested in a randomised controlled trial. This paper reports a qualitative research study to determine the usefulness and acceptability of the NAT-C in the Australian primary care setting. Convenience samples of 11 carers and 5 GPs were interviewed between September 2010 and December 2011 regarding their experiences with and perceptions of the NAT-C. Open-ended questions were used, and the transcripts were analysed qualitatively to identify themes and patterns. Three major themes were identified: (a) Acceptability of the intervention; (b) Impact of the intervention on the GP-patient relationship; and (c) Place of the intervention in advanced cancer care. This simple checklist was acceptable to carers, although some were uncertain about the legitimacy of discussing their own needs with their GP. Carer-patients could not be certain whether a GP would be willing or equipped to conduct a NAT-C-based consultation. Such consultations were acceptable to most GPs, although some already used a holistic approach while others preferred brief symptom-based consultations. Although the NAT-C was acceptable to most carers and GPs, supportive consultations take time. This raises organisational issues to be addressed so carers can seek and benefit from their GP's support.
非专业护理角色对于晚期癌症护理至关重要,但却使护理者的健康面临风险。如果初级非专业护理者披露自身担忧,支持性的全科医生(GP)能够帮助他们管理自身健康。为护理者开发了一种护理者需求评估工具(NAT-C),供其自行填写并作为全科医生会诊的基础,随后在一项随机对照试验中进行了测试。本文报告了一项定性研究,以确定NAT-C在澳大利亚初级医疗环境中的实用性和可接受性。在2010年9月至2011年12月期间,对11名护理者和5名全科医生的便利样本进行了访谈,了解他们对NAT-C的体验和看法。使用了开放式问题,并对访谈记录进行了定性分析,以确定主题和模式。确定了三个主要主题:(a)干预措施的可接受性;(b)干预措施对医患关系的影响;(c)干预措施在晚期癌症护理中的地位。尽管一些护理者对于与全科医生讨论自身需求的合理性存在疑虑,但这个简单的清单对他们来说是可以接受的。护理者患者无法确定全科医生是否愿意或有能力进行基于NAT-C的会诊。大多数全科医生接受此类会诊,尽管一些人已经采用了整体方法,而另一些人则更喜欢基于症状的简短会诊。尽管NAT-C为大多数护理者和全科医生所接受,但支持性会诊需要时间。这就引发了一些需要解决的组织问题,以便护理者能够寻求全科医生的支持并从中受益。