Surr Claire A, Kelley Rachael, Griffiths Alys W, Ashley Laura, Cowdell Fiona, Henry Ann, Collinson Michelle, Mason Ellen, Farrin Amanda J
Centre for Dementia Research, School of Health and Community Studies, Leeds Beckett University, Leeds, UK.
School of Social Sciences, Leeds Beckett University, Leeds, UK.
J Geriatr Oncol. 2020 Sep;11(7):1125-1131. doi: 10.1016/j.jgo.2020.03.015. Epub 2020 Apr 4.
Despite cancer and dementia being conditions in which prevalence increases with age, there remains limited research on the cancer treatment and care needs of this population. Our study aimed to address this gap and this paper reports on the role of supportive networks in enabling people with dementia to access cancer treatment and care.
An ethnographic study involving seventeen people with cancer and dementia, 22 relatives and nineteen oncology staff. It comprised observations (46 h) of and informal conversations during oncology appointments attended by people with dementia and their relatives and semi-structured interviews (n = 37) with people living with cancer and dementia, their relatives and staff working in various roles across oncology services. Data were analysed using thematic analysis.
Patients and oncology staff relied on and expected relatives to provide practical and emotional support around cancer treatment and care. Families varied in their ability to provide required support due to extent of the family network, practical issues, knowledge of the patient and their wishes, family conflict and the patient's willingness to accept help. Where no family network was available, support provision was complex and this could compromise access to cancer treatment.
People with comorbid cancer and dementia rely heavily on a supportive family network to access treatment and care. Oncology services need to assess the supportive networks available to individual patients in developing cancer treatment plans. Urgent consideration needs to be given to how those with no family networks can be appropriately supported.
尽管癌症和痴呆症的患病率会随着年龄增长而上升，但针对这一人群的癌症治疗及护理需求的研究仍然有限。我们的研究旨在填补这一空白，本文报告了支持性网络在使痴呆症患者能够获得癌症治疗和护理方面所发挥的作用。
一项人种志研究，涉及17名患有癌症和痴呆症的患者、22名亲属以及19名肿瘤学工作人员。研究包括对痴呆症患者及其亲属参加的肿瘤门诊进行观察（46小时）并进行非正式交谈，以及对患有癌症和痴呆症的患者、他们的亲属以及在肿瘤服务部门担任各种职务的工作人员进行半结构化访谈（n = 37）。采用主题分析法对数据进行分析。
患者和肿瘤学工作人员依赖并期望亲属在癌症治疗和护理方面提供实际和情感上的支持。由于家庭网络的规模、实际问题、对患者及其意愿的了解、家庭冲突以及患者接受帮助的意愿等因素，各家庭提供所需支持的能力各不相同。在没有家庭网络的情况下，提供支持的情况很复杂，这可能会影响癌症治疗的可及性。
患有癌症和痴呆症的患者在很大程度上依赖支持性家庭网络来获得治疗和护理。肿瘤服务部门在制定癌症治疗计划时需要评估个体患者可获得的支持性网络。迫切需要考虑如何为那些没有家庭网络的患者提供适当的支持。
