Xu Melody J, Su David, Deboer Rebecca, Garcia Michael, Tahir Peggy, Anderson Wendy, Kinderman Anne, Braunstein Steve, Sherertz Tracy
Department of Radiation Oncology, University of California San Francisco, 1600 Divisadero St, San Francisco, CA, 94115, USA.
International Cancer Expert Corps, New York, NY, USA.
J Cancer Educ. 2019 Apr;34(2):205-215. doi: 10.1007/s13187-017-1310-8.
Familiarity with principles of palliative care, supportive care, and palliative oncological treatment is essential for providers caring for cancer patients, though this may be challenging in global communities where resources are limited. Herein, we describe the scope of literature on palliative oncological care curricula for providers in resource-limited settings. A systematic literature review was conducted using PubMed, Embase, Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Med Ed Portal databases, and gray literature. All available prospective cohort studies, case reports, and narratives published up to July 2017 were eligible for review. Fourteen articles were identified and referenced palliative care education programs in Argentina, Uganda, Kenya, Australia, Germany, the USA, or multiple countries. The most common teaching strategy was lecture-based, followed by mentorship and experiential learning involving role play and simulation. Education topics included core principles of palliative care, pain and symptom management, and communication skills. Two programs included additional topics specific to the underserved or American Indian/Alaskan Native community. Only one program discussed supportive cancer care, and no program reported educational content on resource-stratified decision-making for palliative oncological treatment. Five programs reported positive participant satisfaction, and three programs described objective metrics of increased educational or research activity. There is scant literature on effective curricula for providers treating cancer patients in resource-limited settings. Emphasizing supportive cancer care and palliative oncologic treatments may help address gaps in education; increased outcome reporting may help define the impact of palliative care curriculum within resource-limited communities.
对于照顾癌症患者的医护人员来说,熟悉姑息治疗、支持性护理和姑息性肿瘤治疗的原则至关重要,不过在资源有限的全球社区中,这可能具有挑战性。在此,我们描述了针对资源有限环境中医护人员的姑息性肿瘤护理课程的文献范围。使用PubMed、Embase、Cochrane图书馆、科学网、护理及相关健康文献累积索引、医学教育门户数据库和灰色文献进行了系统的文献综述。截至2017年7月发表的所有可用前瞻性队列研究、病例报告和叙述均符合综述条件。共识别出14篇文章,这些文章提到了阿根廷、乌干达、肯尼亚、澳大利亚、德国、美国或多个国家的姑息治疗教育项目。最常见的教学策略是以讲座为主,其次是指导以及涉及角色扮演和模拟的体验式学习。教育主题包括姑息治疗的核心原则、疼痛和症状管理以及沟通技巧。有两个项目纳入了针对弱势群体或美国印第安/阿拉斯加原住民社区的特定主题。只有一个项目讨论了癌症支持性护理,没有项目报告关于姑息性肿瘤治疗资源分层决策的教育内容。五个项目报告了参与者的积极满意度,三个项目描述了教育或研究活动增加的客观指标。关于在资源有限环境中治疗癌症患者的医护人员的有效课程的文献很少。强调癌症支持性护理和姑息性肿瘤治疗可能有助于弥补教育差距;增加结果报告可能有助于确定姑息治疗课程在资源有限社区中的影响。