Williamson S, Beaver K, Gardner A, Martin-Hirsch P
School of Health Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK.
School of Health Sciences, University of Central Lancashire, Preston, Lancashire PR1 2HE, UK.
Eur J Oncol Nurs. 2018 Jun;34:61-67. doi: 10.1016/j.ejon.2018.02.005. Epub 2018 Mar 14.
Endometrial cancer is the sixth most common female cancer worldwide. There is little evidence that routine hospital surveillance increases survival or decreases morbidity following treatment. Gynaecology Oncology clinical nurse specialists (CNSs) are ideally placed to provide the care, information and support to enable women with a gynaecological cancer to self-manage and live well. A multi-centre randomised controlled trial (RCT) compared hospital follow-up (HFU) with telephone follow-up (TFU) by CNSs. The structured telephone intervention focused on information provision to meet patients psychosocial and information needs. This study aimed to explore the views of women who had received TFU and the CNS's who had delivered the service.
A qualitative study to complement the RCT using semi-structured interviews was conducted. Twenty-five patients were randomly selected from participants in the TFU arm stratified by study site. Seven CNSs were interviewed.
Patient and CNS regarded TFU positively; Three themes emerged from the patient interviews; Convenient Care, Discrete Personalised Care, Confidence and Reassurance. Themes arising from the CNS interviews were Patient Centred Care, Holistic Care and, Confidence and Skills. Patients found that TFU with CNS's was convenient and enabled discussion of issues and information provision at time-points relevant to them. The CNS's found the structured format of TFU enabled them to utilise their skills and knowledge to identify and meet patients holistic needs.
Alternative models of care such as TFU provided by CNSs provides the care, information and support to enable women treated for endometrial cancer to self-manage and live well.
子宫内膜癌是全球第六大常见的女性癌症。几乎没有证据表明常规医院监测能提高生存率或降低治疗后的发病率。妇科肿瘤临床护理专家（CNSs）非常适合提供护理、信息和支持，以使患有妇科癌症的女性能够自我管理并过上良好的生活。一项多中心随机对照试验（RCT）比较了医院随访（HFU）与CNSs的电话随访（TFU）。结构化电话干预侧重于提供信息，以满足患者的心理社会和信息需求。本研究旨在探讨接受TFU的女性以及提供该服务的CNSs的观点。
进行了一项定性研究，采用半结构化访谈来补充RCT。从按研究地点分层的TFU组参与者中随机选择25名患者。对7名CNSs进行了访谈。
患者和CNSs对TFU持积极态度；患者访谈中出现了三个主题：便捷护理、个性化私密护理、信心与安心。CNSs访谈中出现的主题是患者中心护理、整体护理以及信心与技能。患者发现与CNSs进行TFU很方便，能够在与她们相关的时间点讨论问题并提供信息。CNSs发现TFU的结构化形式使他们能够利用自己的技能和知识来识别并满足患者的整体需求。
诸如CNSs提供的TFU等替代护理模式能够提供护理、信息和支持，使接受子宫内膜癌治疗的女性能够自我管理并过上良好的生活。
