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癌症患者在医疗就诊期间的姑息治疗需求:定性研究。

Needs of cancer patients in palliative care during medical visits: Qualitative study.

机构信息

Family physician practising in Beloeil, Que.

Associate Professor in the Department of Family and Emergency Medicine in the Faculty of Medicine at the University of Montreal in Quebec.

出版信息

Can Fam Physician. 2017 Dec;63(12):e536-e542.

Abstract

OBJECTIVE

To explore the needs of cancer patients in palliative care and to determine how care providers, including family physicians, could meet these needs more fully.

DESIGN

Qualitative study performed using semistructured interviews.

SETTING

Palliative care departments (ambulatory and intrahospital).

PARTICIPANTS

Twelve patients with a diagnosis of cancer deemed to be in the palliative phase, who had already received either chemotherapy or radiation treatment.

METHODS

The interviews were recorded and transcribed. They were then coded and categorized to identify and define themes describing the participants' experience. Data were collected until new interviews no longer yielded new categories of results.

MAIN FINDINGS

Study participants primarily needed the expertise of their physicians, but they also needed reassurance by means of clear information about their disease, its treatment, and the prognosis delivered over the course of patient-physician visits, and by means of various measures that could act as safety nets. Participants needed to be heard without being judged. In terms of follow-up care, the oncology nurse navigator was just as important as the physician and could stand in for him or her to meet most relational needs and share and explain information on the disease.

CONCLUSION

Non-family physician specialists cannot meet all of the patients' complex needs; throughout the palliative phase, non-family physician specialists need the support of a family physician and an oncology nurse navigator. Each care provider must be made aware of the patient's needs and ensure that they are met, to the best of his or her ability. Failing to do so might exacerbate the loneliness and anxiety experienced by terminally ill patients.

摘要

目的

探讨癌症姑息治疗患者的需求,并确定包括家庭医生在内的医护人员如何能更充分地满足这些需求。

设计

采用半结构式访谈进行的定性研究。

地点

姑息治疗科(门诊和院内)。

参与者

12 名被诊断患有癌症且处于姑息阶段的患者,这些患者已接受化疗或放疗。

方法

对访谈进行录音和转录,然后对其进行编码和分类,以识别和定义描述参与者体验的主题。收集数据直至新访谈不再产生新的结果类别。

主要发现

研究参与者主要需要医生的专业知识,但他们还需要通过在医患访问过程中提供有关疾病、治疗和预后的明确信息来获得安慰,并通过各种可以作为安全网的措施来获得安慰。参与者需要被倾听而不被评判。在后续护理方面,肿瘤护士导航员与医生一样重要,可以代替他/她满足大多数关系需求,并分享和解释疾病信息。

结论

非家庭医生专科医生无法满足患者所有复杂的需求;在姑息治疗阶段,非家庭医生专科医生需要家庭医生和肿瘤护士导航员的支持。每个医护人员都必须了解患者的需求并尽力满足这些需求,否则可能会加剧晚期患者的孤独感和焦虑感。

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