HammondCare Centre for Positive Ageing, Hammondville, NSW, Australia.
University of New South Wales, Kensington, NSW, Australia.
Eur J Cancer Care (Engl). 2019 Nov;28(6):e13162. doi: 10.1111/ecc.13162. Epub 2019 Sep 30.
Scant research explores health professionals' experiences of providing inpatient cancer rehabilitation services, either from the negative or positive perspectives.
This report explores the lived experiences of 14 multidisciplinary health professionals providing cancer rehabilitation services within an inpatient setting. Their interpretations provide a distinctive evaluation of an inpatient, cancer rehabilitation service, both negative and positive, and the impacts of their experiences on them and their patients. Data from semi-structured focus groups and interviews were analysed using Interpretative Phenomenological Analysis (IPA: Psychology and Health, 11, 1996, 261-271) to produce thematic results.
Health professionals' focus groups and interviews produced one superordinate theme: Therapeutic community. Subordinate themes were Healing and Hope, Limited by the System, Moral Integrity and Growth, with further subthemes; Invalidation, Moral dilemmas, Gratitude and Humility. Positive views of the specialist service were tempered with issues associated with finite resources and staff feeling unsupported in their person-centred approach. Although rehabilitation was the primary focus of the unit, metastatic cancer may behave unpredictably; symptom recurrences meant that a dialogue of accepting palliative care and dying as a phase of life was also an important factor raised by some patients and families in our setting. Referral to palliative specialists for this dialogue was incorporated in the context of the rehabilitation care provided.
Study participants provided a unique window, encompassing both negative and positive perspectives, to understanding their deep commitment to quality of care, despite resource limitations. Professionals in this inpatient team worked to provide optimal multidisciplinary services relevant to each individual's need to move towards strength and independence.
几乎没有研究从负面或积极的角度探讨卫生专业人员提供住院癌症康复服务的经验。
本报告探讨了 14 名多学科卫生专业人员在住院环境中提供癌症康复服务的生活体验。他们的解释对住院癌症康复服务提供了独特的评价,既有负面的,也有正面的,以及他们的经验对他们自己和他们的病人的影响。采用解释现象学分析(IPA:心理学与健康,1996 年,第 261-271 页)对半结构焦点小组和访谈数据进行分析,得出主题结果。
卫生专业人员的焦点小组和访谈产生了一个上位主题:治疗社区。下属主题是治愈和希望、受限于系统、道德诚信和成长,还有进一步的下属主题;无效、道德困境、感激和谦逊。对专科服务的积极看法受到与有限资源相关的问题以及工作人员在以患者为中心的方法中感到不受支持的问题所影响。虽然康复是该单位的主要重点,但转移性癌症的行为可能不可预测;症状复发意味着接受姑息治疗和将死亡视为生命的一个阶段也是我们环境中一些患者和家庭提出的一个重要因素。在提供康复护理的背景下,将这种对话转介给姑息治疗专家。
研究参与者提供了一个独特的视角,包括负面和积极的观点,以了解他们对护理质量的深刻承诺,尽管资源有限。该住院团队的专业人员努力提供与每个人向力量和独立迈进的需求相关的最佳多学科服务。