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确定儿童癌症幸存者过渡性护理实践的成功指标:对幸存者护理提供者的定性研究

Identifying metrics of success for transitional care practices in childhood cancer survivorship: A qualitative study of survivorship providers.

作者信息

Sadak Karim Thomas, Neglia Joseph P, Freyer David R, Harwood Eileen

机构信息

University of Minnesota Masonic Children's Hospital, University of Minnesota Masonic Cancer Center, Minneapolis, Minnesota.

Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California.

出版信息

Pediatr Blood Cancer. 2017 Nov;64(11). doi: 10.1002/pbc.26587. Epub 2017 May 30.

Abstract

BACKGROUND

Long-term survival in childhood cancer is excellent. Most survivors will have a therapy-related chronic condition, yet very few receive survivor-focused care as they transition from adolescence to young adulthood. The purpose of this study is to identify indicators of success in current transitional care practices for young adult survivors of childhood cancer as defined by all members of survivorship care teams.

PROCEDURE

An exploratory, phenomenologic qualitative study was conducted with key informants from medical teams involved in transitional care of childhood cancer survivors. Data were collected through phone interviews with providers from both pediatric and adult care settings.

RESULTS

A multidisciplinary study sample of 29 participants from three institutions identified two major themes with multiple subthemes. The first major theme was that providers must be good communicators, and it emphasized the importance of having good relationships throughout the transition of care to optimize effective communication. The second major theme was that models of care must include well-established partners throughout the healthcare system that promote accessible subspecialty care with streamlined referrals and patient navigation services.

CONCLUSIONS

From the perspective of experienced pediatric- and adult-centered providers at three different institutions delivering life-long transitional care for childhood cancer survivors, the optimal model of care must be built around facilitating communication among all key stakeholders and emphasizing patient-friendly services that minimize patient stressors.

摘要

背景

儿童癌症患者的长期生存率很高。大多数幸存者会患有与治疗相关的慢性病,但在他们从青少年过渡到青年期时,很少有人接受以幸存者为中心的护理。本研究的目的是确定儿童癌症青年幸存者当前过渡性护理实践中的成功指标,这些指标由幸存者护理团队的所有成员定义。

程序

对参与儿童癌症幸存者过渡性护理的医疗团队的关键信息提供者进行了一项探索性的现象学定性研究。通过电话采访儿科和成人护理机构的提供者收集数据。

结果

来自三个机构的29名参与者组成的多学科研究样本确定了两个主要主题及多个子主题。第一个主要主题是提供者必须善于沟通,它强调在整个护理过渡过程中建立良好关系对于优化有效沟通的重要性。第二个主要主题是护理模式必须在整个医疗系统中包括成熟的合作伙伴,这些合作伙伴通过简化转诊和患者导航服务来促进可及的专科护理。

结论

从在三个不同机构为儿童癌症幸存者提供终身过渡性护理的经验丰富的以儿科和成人护理为中心的提供者的角度来看,最佳护理模式必须围绕促进所有关键利益相关者之间的沟通以及强调尽量减少患者压力源的患者友好型服务来构建。

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