一种综合知识转化方法，用于制定一项共享决策策略，供因纽特人在癌症护理中使用：一项定性研究。
An integrated knowledge translation approach to develop a shared decision-making strategy for use by Inuit in cancer care: a qualitative study.
机构信息
School of Rehabilitation Therapy, Queen's University, Kingston, ON.
Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, ON.
出版信息
Curr Oncol. 2019 Jun;26(3):192-204. doi: 10.3747/co.26.4729. Epub 2019 Jun 1.
BACKGROUND
In relation to the general Canadian population, Inuit face increased cancer risks and barriers to health services use. In shared decision-making (sdm), health care providers and patients make health care decisions together. Enhanced participation in cancer care decisions is a need for Inuit. Integrated knowledge translation (kt) supports the development of research evidence that is likely to be patient-centred and applied in practice.
OBJECTIVE
Using an integrated kt approach, we set out to promote the use of sdm by Inuit in cancer care.
METHODS
An integrated kt study involving researchers with a Steering Committee of cancer care system partners who support Inuit in cancer care ("the team") consisted of 2 theory-driven phases:■ using consensus-building methods to tailor a previously developed sdm strategy and developing training in the sdm strategy; and■ training community support workers (csws) in the sdm strategy and testing the sdm strategy with community members.
RESULTS
The team developed a sdm strategy that included a workshop and a booklet with 6 questions for use by csws with patients. The sdm strategy (training and booklet) was finalized based on feedback from 5 urban-based Inuit csws who were recruited and trained in using the strategy. Trained csws were matched with 8 community members, and use of the sdm strategy was assessed during interviews, reported as 6 themes. Participants found the sdm strategy to be useful and feasible for use.
CONCLUSIONS
An integrated kt approach of structured research processes with partners developed a sdm strategy for use by Inuit in cancer care. Further work is needed to test the sdm strategy.
背景
相较于加拿大普通民众，因纽特人面临更高的癌症风险，且在使用医疗服务方面存在更多障碍。在共同决策（sdm）中，医疗保健提供者和患者共同做出医疗保健决策。增强因纽特人在癌症护理决策中的参与度是一项需求。综合知识转化（kt）支持开发可能以患者为中心且适用于实践的研究证据。
目的
我们采用综合 kt 方法，旨在促进因纽特人在癌症护理中使用 sdm。
方法
一项综合 kt 研究涉及具有癌症护理系统合作伙伴指导委员会的研究人员，这些合作伙伴支持因纽特人的癌症护理（“团队”），由 2 个理论驱动阶段组成：
使用共识建立方法调整先前开发的 sdm 策略，并制定 sdm 策略培训；
培训社区支持工作者（csws）使用 sdm 策略，并在社区成员中测试 sdm 策略。
结果
团队制定了一项 sdm 策略，其中包括一个讲习班和一本小册子，供 csws 与患者一起使用，共包含 6 个问题。该 sdm 策略（培训和小册子）是基于 5 名招募并接受使用该策略培训的城市因纽特 csw 的反馈意见而最终确定的。经过培训的 csw 与 8 名社区成员相匹配，并在访谈中评估了 sdm 策略的使用情况，报告了 6 个主题。参与者发现 sdm 策略对于癌症护理中的使用是有用且可行的。
结论
通过与合作伙伴一起采用结构化研究流程的综合 kt 方法，为因纽特人在癌症护理中制定了 sdm 策略。需要进一步工作来测试 sdm 策略。
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