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克服综合支持性癌症护理中的沟通挑战:综合医生、心理肿瘤学家与患者

Overcoming communication challenges in integrative supportive cancer care: The integrative physician, the psycho-oncologist, and the patient.

作者信息

Ben-Arye Eran, Shavit Efrat, Wiental Haya, Schiff Elad, Agour Olga, Samuels Noah

机构信息

Integrative Oncology Program, The Oncology Service, Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Israel; Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Clalit Health Services, Haifa and Western Galilee District, Israel.

Social-Work Service, The Oncology Service and Lin Medical center, Clalit Health Services, Haifa and Western Galilee District, Israel.

出版信息

Complement Ther Med. 2016 Dec;29:9-15. doi: 10.1016/j.ctim.2016.09.001. Epub 2016 Sep 4.

Abstract

BACKGROUND

Complementary/integrative medicine (CIM) services are increasingly being integrated into conventional supportive cancer care, presenting a number of challenges to communication between healthcare professionals (HCPs). The purpose of the present study was to explore the impact of the communication between integrative physicians (IPs) trained in CIM and social workers (SWs) working as psycho-oncologists in the same oncology setting. We examine whether IP-SW communication correlates with the number of patient-SW sessions, as provided within the oncology department.

METHODS

SW-IP communication, defined as a summary of the IP consultation sent to the patient's SW, was compared to SW-patient communication, defined as the number of psycho-oncology treatment sessions.

RESULTS

Of 344 patients referred by their oncology HCP for IP consultation, 91 were referred by an SW and 253 by an oncologist or nurse. IP-to-SW summaries were provided for 150 patients referred by a non-SW HCP (43.6%), and for 91 of SW-referred patients (26.5%). In all, 32 patients referred to the IP had no psycho-oncology interaction with an SW; 58 only one meeting; and 254 with ≥2 interactions, with 119 having >6 sessions. SW-patient interactions were greater with higher rates of IP-SW communication, for both patients referred by an SW (79.1%) and those referred by a non-SW HCP (77.3%) when compared to patients for whom no summary was provided (64.1%; p= 0.02).

CONCLUSION

A greater level of IP-SW communication, measured by the provision of an IP summary to the patient's SW, was found to correlate with a higher rate of SW-patient interactions. The use of a structured two-way referral-summary between IPs and SWs has the potential to advance the SW-patient psycho-oncology interaction, within an integrative supportive cancer care setting.

摘要

背景

补充/整合医学(CIM)服务越来越多地被纳入传统的癌症支持治疗中,这给医护人员(HCPs)之间的沟通带来了诸多挑战。本研究的目的是探讨接受过CIM培训的整合医学医生(IPs)与在同一肿瘤环境中担任心理肿瘤学家的社会工作者(SWs)之间的沟通所产生的影响。我们研究了IP-SW沟通是否与肿瘤科室提供的患者-SW会诊次数相关。

方法

将SW-IP沟通(定义为发送给患者SW的IP会诊总结)与SW-患者沟通(定义为心理肿瘤治疗会诊次数)进行比较。

结果

在344名由肿瘤HCP转介进行IP会诊的患者中,91名由SW转介,253名由肿瘤学家或护士转介。为150名由非SW HCP转介的患者(43.6%)以及91名由SW转介的患者(26.5%)提供了IP-to-SW总结。总共有32名转介给IP的患者与SW没有心理肿瘤学互动;58名患者只有一次会诊;254名患者有≥2次互动,其中119名患者有>6次会诊。与未提供总结的患者(64.1%;p = 0.02)相比,对于由SW转介的患者(79.1%)和由非SW HCP转介的患者(77.3%),随着IP-SW沟通率的提高,SW-患者互动更多。

结论

通过向患者的SW提供IP总结来衡量,更高水平的IP-SW沟通与更高的SW-患者互动率相关。在整合性癌症支持治疗环境中,在IP和SW之间使用结构化的双向转诊总结有可能促进SW-患者心理肿瘤学互动。

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