Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe, Box 457, 405 30, Göteborg, Sweden.
Department of Nursing, Umeå University, Umeå, Sweden.
Support Care Cancer. 2019 Jul;27(7):2679-2691. doi: 10.1007/s00520-018-4557-7. Epub 2018 Nov 27.
Patients with brain tumors constitute a vulnerable group, and it is important that they receive the highest quality of care (QoC). The study aim was to describe the perceptions of QoC and its association with health-related quality of life in brain tumor patients undergoing proton beam therapy in a newly established clinic.
Data were collected at the start of treatment and after 3 and 6 weeks. Adult patients (≥ 18 years old) with brain tumors (n = 186) completed two self-administered questionnaires: a modified Quality from the Patients' Perspective, which measures perceived reality and subjective importance of care, and the EORTC QLQ-C30. Data were analyzed using parametric and non-parametric statistical tests.
The perceived QoC was highest for treatment information and lowest for dietician and smoking information, whereas interaction with doctors and nurses was rated as the most important aspect of quality of care. Subjective importance ratings were significantly higher than perceived reality ratings for 60% of items. A better global health was moderately correlated with a higher perceived support for fatigue.
A need for quality improvement was identified for several aspects of patient care. Greater symptom distress during the treatment period led to greater perceived importance of symptom support. Ensuring QoC is complex and collaboration with other health care professionals is essential.
The clinic could improve QoC regarding information about possible symptoms, adjust care according to patient perceptions of importance, and involve patients in care decisions.
脑瘤患者属于弱势群体,为其提供高质量的护理(QoC)至关重要。本研究旨在描述接受质子束治疗的脑瘤患者对 QoC 的感知及其与健康相关生活质量的相关性,该研究在新成立的诊所中开展。
在治疗开始时、治疗后 3 周和 6 周收集数据。186 名脑瘤成年患者(≥18 岁)完成了两份自我管理问卷:一份改良版的从患者角度感知的 QoC,用于测量患者对护理的感知现实和主观重要性;另一份是 EORTC QLQ-C30。使用参数和非参数统计检验对数据进行分析。
患者对治疗信息的 QoC 感知最高,对营养师和吸烟信息的 QoC 感知最低,而与医生和护士的互动被评为护理质量最重要的方面。主观重要性评分显著高于感知现实评分的项目占比为 60%。总体健康状况越好,对疲劳的支持感知越高。
患者护理的几个方面都需要进行质量改进。在治疗期间症状越严重,患者对症状支持的感知就越重要。确保 QoC 是一项复杂的工作,与其他医疗保健专业人员的合作至关重要。
该诊所可以提高关于可能出现的症状的信息质量,根据患者对重要性的感知来调整护理,并让患者参与护理决策。