Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
PLoS One. 2019 Jan 16;14(1):e0210325. doi: 10.1371/journal.pone.0210325. eCollection 2019.
As worldwide cancer prevalence continues to increase, the challenges facing cancer care are also increasing. Various topics related to deficiencies in cancer care have been discussed repeatedly in the literature. The most frequently stated topics are the unmet psychosocial support needs of cancer patients, difficulties in multidisciplinary teamwork, difficulties in communication between physicians and patients, and issues in palliative care settings. However, there is little research regarding the views of health care providers on these topics. With the aim of gaining abundant information regarding the care of German cancer patients, this study explores the stances of psycho-oncologists, physicians, and nurses regarding the quality of cancer care.
Semi-structured interviews were conducted at the University Medical Center Hamburg-Eppendorf (UKE) and in different oncological outpatient offices in Hamburg; twenty-five interviews in total were conducted with health care providers. Interviews were semi-structured to gain a broad range of information on cancer care. The data were analyzed using thematic analysis by Braun and Clarke with an inductive, constant comparison approach to identify themes and categorized codes.
The following five principle themes were identified in the interviews: "psycho-oncological care", "cooperation of health care providers", "palliative care", "health care provider-patient contact", and "coordination and organization of care". Participants seemed satisfied with the overall quality of cancer care in Germany. Nevertheless, the results showed deficiencies regarding communication among different health care providers and between health care providers and patients. Important findings in conjunction with these communication problems were a lack of psycho-oncological support, shortages in the oncology work force, language and cultural barriers, and deficient education in the communication of providers.
The statements of psycho-oncologists, physicians, and nurses on cancer care provide a suitable basis to conduct further focused research on the studied deficiencies in cancer care. In particular, communication in psycho-oncological care, communication within multidisciplinary teams, and health care provider-patient communication should be further explored with the aim of developing new ideas for improvements and thereby enhancing the quality of cancer care.
随着全球癌症发病率的持续上升,癌症护理面临的挑战也在不断增加。文献中反复讨论了与癌症护理缺陷相关的各种主题。最常提到的主题是癌症患者未得到满足的心理社会支持需求、多学科团队合作困难、医生与患者沟通困难以及姑息治疗环境中的问题。然而,关于医疗保健提供者对这些主题的看法的研究甚少。为了充分了解德国癌症患者的护理情况,本研究探讨了心理肿瘤学家、医生和护士对癌症护理质量的看法。
在汉堡大学医学中心(UKE)和汉堡不同的肿瘤门诊办公室进行了半结构化访谈;共对 25 名医疗保健提供者进行了访谈。访谈采用半结构化方式,以广泛了解癌症护理信息。使用 Braun 和 Clarke 的主题分析法对数据进行分析,采用归纳法和恒定性比较方法来识别主题和分类代码。
访谈中确定了以下五个主要主题:“心理肿瘤学护理”、“医疗保健提供者之间的合作”、“姑息治疗”、“医患接触”和“护理的协调与组织”。参与者对德国癌症护理的整体质量感到满意。然而,结果显示不同医疗保健提供者之间以及医疗保健提供者与患者之间的沟通存在缺陷。与这些沟通问题相关的重要发现包括心理肿瘤学支持不足、肿瘤学劳动力短缺、语言和文化障碍以及提供者沟通教育不足。
心理肿瘤学家、医生和护士对癌症护理的陈述为进一步研究癌症护理缺陷提供了合适的基础。特别是,应进一步探讨心理肿瘤学护理中的沟通、多学科团队内部的沟通以及医患沟通,以制定改善的新想法,从而提高癌症护理质量。