School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
Carrington Health, Melbourne, Victoria, Australia.
J Cancer Surviv. 2020 Feb;14(1):36-42. doi: 10.1007/s11764-019-00821-6. Epub 2019 Nov 9.
This study aimed to establish and evaluate the referral pathway from a hospital-based oncology service to a multidisciplinary community-based health service supporting survivors to engage in self-management.
The evaluation involved understanding patterns of health service utilisation and health professionals' perspectives on the implementation of the community-based model of survivorship care, the Good Life Cancer Survivorship (GLCS) program. Survivors referred to GLCS were undergoing or had completed cancer treatment and unable to participate in intensive ambulatory oncology rehabilitation. Health service utilisation was tracked over 5 months, and the perspectives of health professionals referring to and involved in the GLCS program were recorded using semi-structured interviews.
The oncology service made 25 referrals. The most accessed services at Carrington Health were physiotherapy with 18 appointments, followed by psychology (12) and dietitian services (11). Four themes emerged from the interviews: (1) Allied health services are relevant to people with cancer; (2) Education and information needs; (3) Communication gaps; (4) A one-stop multidisciplinary and holistic care model.
This project demonstrated that community health may be a valid setting to support cancer survivors in managing their health. Supporting ongoing awareness, education and understanding of services across both community and acute care settings will foster care coordination and strengthen referral pathways.
Accessing appropriate community-based allied health services can support cancer survivors in developing self-management skills to manage their own health and improve their health outcomes and wellbeing in the survivorship phase.
本研究旨在建立并评估一种从医院肿瘤专科服务向多学科社区健康服务的转诊途径,以支持生存者进行自我管理。
该评估包括了解卫生服务利用模式以及卫生专业人员对基于社区的生存者关怀模式(即良好生活癌症生存者计划,GLCS)实施情况的看法。转介至 GLCS 的生存者正在接受或已完成癌症治疗,无法参加强化门诊肿瘤康复。对生存者的卫生服务利用情况进行了 5 个月的跟踪,并通过半结构化访谈记录了向 GLCS 转介和参与该项目的卫生专业人员的观点。
肿瘤专科服务共转介了 25 例患者。在 Carrington Health,接受最多的服务是物理治疗,共 18 次预约,其次是心理学(12 次)和营养师服务(11 次)。访谈中出现了 4 个主题:(1) 康复服务对癌症患者具有相关性;(2) 教育和信息需求;(3) 沟通障碍;(4) 一站式多学科和整体关怀模式。
本项目表明,社区卫生服务可能是支持癌症生存者管理健康的有效场所。在社区和急性护理环境中,支持对服务的持续了解、教育和理解将促进护理协调并加强转诊途径。
获得适当的基于社区的康复服务可以帮助癌症生存者发展自我管理技能,以管理自己的健康,并在生存阶段改善健康结果和幸福感。