头颈部肿瘤患者管理的范式转变。
Paradigm shift in head and neck oncology patient management.
机构信息
Department Oral & Maxillofacial Surgery and Special Dental Care, University Medical Center Groningen, P.O. box 30.001, 9700 RB, Groningen, The Netherlands.
Faculty of Social and Behavioral Sciences, University of Amsterdam, Weesperplein 4, 1018 XA, Amsterdam, The Netherlands.
出版信息
J Otolaryngol Head Neck Surg. 2017 Sep 19;46(1):57. doi: 10.1186/s40463-017-0229-8.
OBJECTIVE
This article describes a paradigm shift in what is considered to be good care for patients living with and after (head and neck) cancer. HNO patients often experience severe and difficult physical and psychosocial problems due to the nature and location of the disease. Many disciplines are involved in their treatment, so their voice is only one amongst many others in the decision making process. For this patient group it seems complicated to put the concept of Shared Decision Making into practice. As a step in this direction, patient reported outcomes which ask patients to select the disconcerting issues and symptoms can be used as a basis for referral, supportive care and treatment decision making. We need to provide more tailored and personalized information that is specific to individual circumstances, preferences and concerns and focuses more on the impact of treatment and access to help and support. Follow up of these patients should be concentrated on both medical and emotional aspects.
PRACTICE IMPLICATIONS
A shift in the way caregivers provide their information contributes to a more profound involvement of patients in treatment decisions.
目的
本文描述了一种观念转变，即人们认为良好的医疗护理应该是什么样的，适用于那些患有（头颈部）癌症及癌症康复后的患者。由于疾病的性质和位置，HNO 患者常常经历严重且困难的身体和心理社会问题。许多学科都参与到他们的治疗中，因此他们的意见只是决策过程中的众多意见之一。对于这群患者来说，实施共同决策的概念似乎很复杂。作为这一方向的一个步骤，可以使用患者报告的结果来询问患者选择令人困扰的问题和症状，作为转介、支持性护理和治疗决策的基础。我们需要提供更具针对性和个性化的信息，这些信息要具体到个人情况、偏好和关注点，并更加注重治疗的影响以及获得帮助和支持的途径。对这些患者的随访应该集中在医疗和情感两个方面。
实践意义
护理人员提供信息方式的转变有助于让患者更深入地参与治疗决策。
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