1 Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia.
2 Victorian Comprehensive Cancer Centre, Parkville, VIC, Australia.
Palliat Med. 2018 Feb;32(2):439-446. doi: 10.1177/0269216317735724. Epub 2017 Nov 13.
Despite being a common event in the course of an advanced cancer illness, there is little understanding of patients' perceptions of hospital Emergency Department presentations.
To explore the experiences and perceptions of Emergency Departments held by patients with advanced cancer and their informal caregivers.
Cross-sectional study involving semi-structured interviews with advanced cancer patients and their informal caregivers. Qualitative data analysis was underpinned by a phenomenological approach utilising a data-driven inductive thematic frame.
SETTING/PARTICIPANTS: In total, 19 patients with advanced cancer who presented to Emergency Departments in the previous 6 months and 10 informal caregivers from an Australian public hospital and community palliative care service were interviewed.
Patients reported that Emergency Department presentations were largely prompted by worsening symptoms or were a means to expedite hospital admission, with many instructed to attend by their health care provider. The experience in the Emergency Department was described as a time of anxiety and uncertainty with concerns over communication, the general environment and delays in the symptom management highlighted. Long waits were common. Despite this, patients described relief at receiving care. While the Emergency Department was viewed as a safety net for the health system, many believed advanced cancer patients should have alternative options.
Relatively simple changes of regular communication updates and early symptom relief would improve patient experience of Emergency Department care. However, since an Emergency Department presentation is frequently serving as a default to access medical care, a significant re-orientation of the health care system is required to meet patient needs.
尽管在晚期癌症疾病的病程中经常发生，但人们对患者对急诊科就诊的看法知之甚少。
探讨晚期癌症患者及其非专业照护者对急诊科就诊的体验和看法。
一项横断面研究，涉及对在过去 6 个月内到急诊科就诊的晚期癌症患者及其非专业照护者进行半结构式访谈。使用基于数据的归纳主题框架的现象学方法为定性数据分析提供了依据。
地点/参与者：共有 19 名在过去 6 个月内到急诊科就诊的晚期癌症患者和 10 名来自澳大利亚公立医院和社区姑息治疗服务的非专业照护者接受了采访。
患者报告说，急诊科就诊主要是由于症状恶化或作为加快住院的手段，许多人是根据医疗保健提供者的指示就诊的。他们在急诊科的经历被描述为焦虑和不确定的时期，对沟通、整体环境和症状管理的延迟感到担忧。长时间的等待是很常见的。尽管如此，患者还是表示在接受治疗后感到如释重负。尽管急诊科被视为卫生系统的安全网，但许多人认为晚期癌症患者应该有其他选择。
定期进行沟通更新和早期症状缓解等相对简单的改变，将改善患者对急诊科护理的体验。然而，由于急诊科就诊常常是获得医疗护理的默认方式，因此需要对医疗保健系统进行重大调整，以满足患者的需求。
