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乳腺护理护士的影响:对麦格拉思基金会乳腺护理护士倡议的评估

The Impact of Breast Care Nurses: An Evaluation of the McGrath Foundation's Breast Care Nurse Initiative.

作者信息

Mahony Jane, Masters Holly, Townsend James, Hagerty Fionnuala, Fodero Lisa, Scuteri Joe, Doromal Darren

机构信息

McGrath Foundation, Sydney, NSW, Australia.

HealthConsult, Sydney, NSW, Australia.

出版信息

Asia Pac J Oncol Nurs. 2019 Jan-Mar;6(1):28-34. doi: 10.4103/apjon.apjon_61_18.

Abstract

OBJECTIVE

Over the four years to 30 June, 2017 the McGrath Foundation's Second Federal Government Breast Care Nurse (BCN) Initiative funded 57 McGrath BCNs (MBCNs) to deliver better continuity of care and provide specialized support to those diagnosed with and undergoing treatment for breast cancer. This article summarizes the findings generated through a mixed-method evaluation of the program's appropriateness, effectiveness, and efficiency.

METHODS

The evaluation comprised surveys and semi-structured interviews with patients, multidisciplinary clinicians and MBCNs. The research also drew on secondary materials, including MBCN activity and patient caseload data, a review of existing programs and costing information.

RESULTS

The evaluation generated evidence that access to an MBCN results in an improved experience for patients and clinicians, and that these impacts are more profound when MBCNs come into contact with their patients at the time of diagnosis. The economic modeling component of the evaluation revealed that there are cost savings to the health system when breast cancer patients have early access to an MBCN (through reduced health service utilization). The net saving produced by the program was estimated to be worth $6,323,257 per year, or $1,527 per new breast cancer patient seen. Stakeholders indicated that the MBCN model of care could be evolved to respond to emerging trends in breast cancer care pathways, such as a greater role in survivorship.

CONCLUSION

This research advances the current understanding of the impact of BCNs on different levels of the health system and holds relevance for health-care funders, providers, and policy-makers. The evaluation demonstrates that access to an MBCN results in an improved experience for patients and clinicians, along with savings to the health system (through reduced health service utilization). The evaluation also shows that these impacts are more profound when MBCNs come into contact with their patients at the time of diagnosis.

摘要

目的

截至2017年6月30日的四年间,麦格拉思基金会的第二项联邦政府乳腺护理护士(BCN)倡议资助了57名麦格拉思乳腺护理护士(MBCN),以提供更好的连续性护理,并为那些被诊断患有乳腺癌并正在接受治疗的患者提供专门支持。本文总结了通过对该项目的适宜性、有效性和效率进行混合方法评估而得出的结果。

方法

该评估包括对患者、多学科临床医生和MBCN进行调查和半结构化访谈。该研究还借鉴了二手资料,包括MBCN的活动和患者病例数据、对现有项目的审查以及成本信息。

结果

评估产生的证据表明,接触MBCN能改善患者和临床医生的体验,并且当MBCN在诊断时与患者接触时,这些影响更为深远。评估的经济建模部分显示,乳腺癌患者能尽早接触MBCN(通过减少医疗服务利用)时,卫生系统会节省成本。该项目产生的净节省估计每年价值6323257美元,即每位新就诊的乳腺癌患者节省1527美元。利益相关者表示,MBCN护理模式可以发展以应对乳腺癌护理路径中的新趋势,例如在康复期发挥更大作用。

结论

本研究推进了当前对BCN对卫生系统不同层面影响的理解,对医疗保健资助者、提供者和政策制定者具有参考价值。评估表明,接触MBCN能改善患者和临床医生的体验,同时为卫生系统节省成本(通过减少医疗服务利用)。评估还表明,当MBCN在诊断时与患者接触时,这些影响更为深远。

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