M02, Sydney Nursing School, The University of Sydney, Sydney, NSW, 2006, Australia.
Cancer Centre, Chris O'Brien Lifehouse, 119 Missenden Road, Camperdown, NSW, Australia.
Support Care Cancer. 2018 Jun;26(6):1791-1797. doi: 10.1007/s00520-017-4021-0. Epub 2017 Dec 16.
Demand for complementary and alternative medicine (CAM) is high among cancer patients. This, alongside growing evidence for the efficacy of some CAM therapies, is driving change within cancer centres, where evidence-based CAM therapies are increasingly provided alongside standard cancer treatments. In Australia, commitment to equitable access to healthcare is strong, and some cancer centres are now providing integrative services at no cost to the patient. This represents a significant shift in healthcare provision. This study aimed to examine health professional and patient dynamics in an integrated cancer service where CAM is provided at no cost to patients alongside standard cancer treatments. It specifically sought to understand what might drive or hinder further integration of CAM with standard treatment in the cancer context.
Qualitative interviews were undertaken with twenty key stakeholders-cancer patients, cancer nurses, and oncologists-who were delivering or receiving care in an Australian public hospital where acupuncture services are provided at no cost to patients alongside standard chemotherapy and radiation treatments.
Findings point to key areas where the concerns and priorities of cancer patients, cancer nurses, and oncologists converge and diverge in ways that reflect core personal and professional interests regarding patient care needs, the evidence base for CAM efficacy and safety, and rising healthcare costs.
Understanding points of convergence and divergence could assist clinicians and service providers in negotiating ways forward for integrative cancer services.
癌症患者对补充和替代医学(CAM)的需求很高。这一点,再加上一些 CAM 疗法疗效的证据不断增加,正在推动癌症中心的变革,在这些中心,基于证据的 CAM 疗法越来越多地与标准癌症治疗同时提供。在澳大利亚,对公平获得医疗保健的承诺非常强烈,一些癌症中心现在正在向患者免费提供综合服务。这代表着医疗保健提供方式的重大转变。本研究旨在检查在提供 CAM 治疗与标准治疗相结合的癌症综合服务中,医疗保健专业人员和患者的动态。它特别试图了解哪些因素可能会推动或阻碍 CAM 与癌症标准治疗的进一步整合。
对二十名关键利益相关者(癌症患者、癌症护士和肿瘤医生)进行了定性访谈,这些利益相关者在澳大利亚一家公立医院提供服务,该医院向患者免费提供针灸服务,同时还提供标准的化疗和放疗。
研究结果指出了癌症患者、癌症护士和肿瘤医生的关注点和优先事项在哪些方面存在趋同和分歧,这些趋同和分歧反映了他们在患者护理需求、CAM 疗效和安全性的证据基础以及不断上升的医疗保健成本方面的核心个人和专业利益。
了解趋同和分歧的要点可以帮助临床医生和服务提供者为综合癌症服务协商前进的道路。