Kotronoulas Grigorios, Papadopoulou Constantina, Burns-Cunningham Kathryn, Simpson Mhairi, Maguire Roma
Department of Computer and Information Sciences, University of Strathclyde, Glasgow, UK.
School of Health, Nursing and Midwifery, University of the West of Scotland, Paisley, UK.
Eur J Oncol Nurs. 2017 Aug;29:60-70. doi: 10.1016/j.ejon.2017.05.004. Epub 2017 May 30.
Gaining a clear understanding of the health needs and concerns of people with cancer of the colon and/or rectum can help identify ways to offer a comprehensive care package. Our aim was to systematically assess the relevant literature and synthesise current available evidence.
A systematic review was conducted according to the PRISMA Statement guidelines. Five electronic databases were searched to identify studies employing qualitative and/or quantitative methods. Pre-specified selection criteria were applied to all retrieved records. Findings were integrated in a narrative synthesis.
Of 3709 references initially retrieved, 54 unique studies were retained. A total of 136 individual needs were identified and classified into eight domains. Just over half of the needs (70; 51%) concerned information/education or health system/patient-clinician communication issues. Emotional support and reassurance when trying to deal with fear of cancer recurrence featured as the most prominent need regardless of clinical stage or phase of treatment. Information about diet/nutrition and about long-term self-management of symptoms and complications at home; tackling issues relating to the quality and mode of delivery of health-related information; help with controlling fatigue; and on-going contact with a trustworthy health professional also featured as salient needs. Available research evidence is of moderate-to-good quality.
Investing time to sensitively inquire about the supportive care needs of this patient population is key, whilst evaluating and re-shaping clinical interactions based on patients' priorities is equally essential. The diverse needs identified require a multi-professional and multi-agency approach to ensure unmet needs are addressed or measures offered.
深入了解结肠癌和/或直肠癌患者的健康需求及担忧,有助于确定提供全面护理方案的方法。我们的目的是系统评估相关文献并综合现有证据。
根据PRISMA声明指南进行系统综述。检索了五个电子数据库,以识别采用定性和/或定量方法的研究。将预先设定的选择标准应用于所有检索到的记录。研究结果通过叙述性综合进行整合。
在最初检索到的3709篇参考文献中,保留了54项独特的研究。共确定了136项个人需求,并分为八个领域。超过一半的需求(70项;51%)涉及信息/教育或卫生系统/患者与临床医生沟通问题。无论临床分期或治疗阶段如何,在应对癌症复发恐惧时的情感支持和安慰是最突出的需求。关于饮食/营养以及在家中对症状和并发症的长期自我管理的信息;解决与健康相关信息的质量和提供方式有关的问题;帮助控制疲劳;以及与值得信赖的卫生专业人员保持持续联系也被视为突出需求。现有研究证据质量中等至良好。
花时间敏感地询问这一患者群体的支持性护理需求至关重要,同时根据患者的优先事项评估和重塑临床互动同样重要。已确定的多样化需求需要多专业和多机构的方法,以确保未满足的需求得到解决或提供相应措施。