Nolte Linda, Kinnane Nicole, Lai-Kwon Julia, Gates Priscilla, Shilkin Pauline, Jefford Michael
Author Affiliations: Australian Cancer Survivorship Centre, a Richard Pratt Legacy, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia (Mss Nolte, Kinnane, Lai-Kwon, Gates, and Shilkin, AProf Jefford); Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia (AProf Jefford); Department of Clinical Haematology, Olivia Newton-John Cancer & Wellness Centre, Austin Health, Heidelberg, Victoria, Australia (Ms Gates); and Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia (AProf Jefford).
Cancer Nurs. 2016 Nov/Dec;39(6):E26-E35. doi: 10.1097/NCC.0000000000000329.
In 2005, the Institute of Medicine recommended that all cancer patients receive a survivorship care plan (SCP). Despite widespread support, few centers have routinely implemented them. Understanding of their impact is limited.
The aims of this study were to examine the impact of SCP delivery on patients and healthcare professionals at an Australian comprehensive cancer center and determine enablers and barriers to implementation.
Six groups were surveyed: (1) patients who had received SCPs; (2) nurse coordinators using SCPs, (3) general practitioners (primary care, GPs) of patients who had received SCPs, (4) clinical service chairs, (5) heads of allied health, and (6) nurse coordinators not using SCPs (nonengaged nurse coordinators). Groups 1 to 3 completed written questionnaires. Groups 4 to 6 participated in semistructured interviews.
Fifty patients, 7 nurse coordinators, 18 GPs, 7 clinical service chairs, 4 heads of allied health, and 8 nonengaged nurse coordinators participated. Eighty-seven percent of patients considered the SCP to be very or somewhat useful; 50% felt it helped them understand their cancer experience. All engaged nurse coordinators reported SCPs to be very or somewhat useful, and 86% believed SCPs improved communication with GPs. General practitioners felt SCPs were very or somewhat useful (67%) and wished to receive SCPs for future patients (83%). Organizational and clinical leadership, multidisciplinary engagement, resourcing, and timing of SCP delivery were considered critical enablers.
Patients and healthcare professionals support the use of SCPs; however, they are resource intensive and require significant organizational support.
Nurses are instrumental to SCP implementation. Attention to enablers and barriers is important for successful implementation.
2005年,医学研究所建议所有癌症患者接受一份生存护理计划(SCP)。尽管得到广泛支持,但很少有中心常规实施这些计划。对其影响的了解有限。
本研究的目的是在澳大利亚一家综合癌症中心检查实施SCP对患者和医护人员的影响,并确定实施的促进因素和障碍。
对六组人员进行了调查:(1)接受过SCP的患者;(2)使用SCP的护士协调员;(3)接受过SCP的患者的全科医生(初级保健医生,GP);(4)临床服务负责人;(5)辅助医疗部门负责人;(6)未使用SCP的护士协调员(未参与的护士协调员)。第1至3组完成了书面问卷。第4至6组参加了半结构化访谈。
50名患者、7名护士协调员、18名全科医生、7名临床服务负责人、4名辅助医疗部门负责人和8名未参与的护士协调员参与了调查。87%的患者认为SCP非常有用或有些有用;50%的患者觉得它帮助他们了解了自己的癌症经历。所有参与的护士协调员都报告说SCP非常有用或有些有用,86%的人认为SCP改善了与全科医生的沟通。全科医生觉得SCP非常有用或有些有用(67%),并希望为未来的患者提供SCP(83%)。组织和临床领导、多学科参与、资源配置以及SCP实施的时机被认为是关键的促进因素。
患者和医护人员支持使用SCP;然而,它们资源密集,需要大量的组织支持。
护士对SCP的实施至关重要。关注促进因素和障碍对成功实施很重要。