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加拿大癌症护理连续性患者体验:CanIMPACT研究结果

Patients' experiences with continuity of cancer care in Canada: Results from the CanIMPACT study.

作者信息

Easley Julie, Miedema Baukje, Carroll June C, O'Brien Mary Ann, Manca Donna P, Grunfeld Eva

机构信息

Research coordinator at the Dalhousie Family Medicine Teaching Unit in Fredericton, NB.

Professor and Director of Research at the Dalhousie Family Medicine Teaching Unit.

出版信息

Can Fam Physician. 2016 Oct;62(10):821-827.

Abstract

OBJECTIVE

To explore patient perspectives on and experiences with the coordination and continuity of cancer care.

DESIGN

Qualitative study using semistructured telephone interviews.

SETTING

Canada.

PARTICIPANTS

Thirty-eight breast and colorectal cancer survivors 1 to 4 years after diagnosis.

METHODS

Using a constructivist grounded theory approach, semistructured telephone interviews were conducted with the participants. The interviews were digitally recorded, transcribed verbatim, and proofread. Transcripts were reviewed to create a focused coding scheme that was used to develop categories for participants' experiences.

MAIN FINDINGS

Although this study focused on the continuity of cancer care, patients described their experiences with cancer care in general, concentrating predominantly on their relationships with individual health care providers (HCPs). Based on patients' experiences, several themes were identified as the core components of providing good continuity and well coordinated care. The most important overarching theme was communication, which overlapped with 4 other themes: patient-HCP relationships, the role of HCPs, lack of access to care, and timely and tailored information.

CONCLUSION

Patients believed that good communication between HCPs and patients was key to improving the overall continuity of cancer care. Continuity of care is an important theoretical concept in cancer care, but it is not easily recognized by patients. They perceive the cancer care continuum and continuity of care as cancer care in general, which is typically framed by the individual relationships with their HCPs. Future research and interventions need to focus on finding and testing ways to improve communication to enhance continuity of cancer care.

摘要

目的

探讨患者对癌症护理协调与连续性的看法及经历。

设计

采用半结构化电话访谈的定性研究。

地点

加拿大。

参与者

38名乳腺癌和结直肠癌幸存者,确诊后1至4年。

方法

采用建构主义扎根理论方法,对参与者进行半结构化电话访谈。访谈进行数字录音、逐字转录并校对。对转录文本进行审查,以创建一个重点编码方案,用于为参与者的经历分类。

主要发现

尽管本研究聚焦于癌症护理的连续性,但患者总体上描述了他们的癌症护理经历,主要集中在他们与个体医疗服务提供者(HCP)的关系上。基于患者的经历,确定了几个主题作为提供良好连续性和协调护理的核心组成部分。最重要的总体主题是沟通,它与其他4个主题重叠:患者与HCP的关系、HCP的角色、获得护理的机会不足以及及时和量身定制的信息。

结论

患者认为HCP与患者之间的良好沟通是改善癌症护理总体连续性的关键。护理连续性是癌症护理中的一个重要理论概念,但患者并不容易认识到。他们将癌症护理连续体和护理连续性视为一般的癌症护理,这通常由他们与HCP的个体关系来界定。未来的研究和干预需要专注于寻找和测试改善沟通的方法,以增强癌症护理的连续性。

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