Malmström Marlene, Rasmussen Birgit H, Bernhardson Britt-Marie, Hajdarevic Senada, Eriksson Lars E, Andersen Rikke Sand, MacArtney John I
The Institute for Palliative Care, Lund University and Region Skåne, Sweden; Lund University, Department of Health Sciences, Lund, Sweden.
The Institute for Palliative Care, Lund University and Region Skåne, Sweden; Lund University, Department of Health Sciences, Lund, Sweden.
Eur J Oncol Nurs. 2018 Jun;34:82-88. doi: 10.1016/j.ejon.2018.04.002.
The emphasis on early diagnosis to improve cancer survival has been a key factor in the development of cancer pathways across Europe. The aim of this analysis was to explore how the emphasis on early diagnosis and timely treatment is reflected in patient's accounts of care, from the first suspicion of colorectal or lung cancer to their treatment in Denmark, England and Sweden.
We recruited 155 patients in Denmark, England and Sweden who were within six months of being diagnosed with lung or colorectal cancer. Data were collected via semi-structured narrative interviews and analysed using a thematic approach.
Participants' accounts of quality of care were closely related to how quickly (or not) diagnosis, treatment and/or healthcare processes went. Kinetic metaphors as a description of care (such as treadmill) could be interpreted positively as participants were willing to forgo some degree of control and accept disruption to their lives to ensure more timely care. Drawing on wider cultural expectations of the benefits of diagnosing and treating cancer quickly, some participants were concerned that the waiting times between interventions might allow time for the cancer to grow.
Initiatives emphasising the timeliness of diagnosis and treatment are reflected in the ways some patients experience their care. However, these accounts were open to further contextualisation about what speed of healthcare processes meant for evaluating the quality of their care. Healthcare professionals could therefore be an important patient resource in providing reassurance and support about the timeliness of diagnosis or treatment.
强调早期诊断以提高癌症生存率一直是欧洲癌症诊疗路径发展的关键因素。本分析的目的是探讨从首次怀疑患有结直肠癌或肺癌到在丹麦、英国和瑞典接受治疗期间，对早期诊断和及时治疗的强调如何在患者的就医经历中得到体现。
我们在丹麦、英国和瑞典招募了155名在确诊肺癌或结直肠癌后六个月内的患者。通过半结构化叙述性访谈收集数据，并采用主题分析法进行分析。
参与者对医疗质量的描述与诊断、治疗和/或医疗过程的进展速度密切相关。将护理描述为动态隐喻（如跑步机）可以得到积极的解读，因为参与者愿意放弃一定程度的控制权，接受生活被打乱，以确保获得更及时的护理。基于对快速诊断和治疗癌症益处的更广泛文化期望，一些参与者担心干预之间的等待时间可能会让癌症有生长的机会。
强调诊断和治疗及时性的举措在一些患者体验其护理的方式中得到了体现。然而，这些描述对于医疗过程的速度对评估其护理质量意味着什么这一问题，仍有待进一步结合具体情况进行阐释。因此，医疗专业人员在就诊断或治疗的及时性提供保证和支持方面，可能是重要的患者资源。
