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采用共同创造方法改编瑞士乳腺癌幸存者的同伴主导自我管理项目。

Adapting a peer-led self-management program for breast cancer survivors in Switzerland using a co-creative approach.

机构信息

Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and University Hospital Lausanne, Lausanne, Switzerland.

Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne and University Hospital Lausanne, Lausanne, Switzerland; International Breast Cancer Study Group (IBCSG), Bern, Switzerland.

出版信息

Patient Educ Couns. 2020 Sep;103(9):1780-1789. doi: 10.1016/j.pec.2020.03.028. Epub 2020 Apr 17.

Abstract

OBJECTIVE

The peer-led Cancer Thriving and Surviving Program (CTS) has demonstrated improved health outcomes for cancer survivors. We describe a co-creative process for adapting the CTS for breast cancer survivors in Switzerland and integrating the program into the clinical pathway of Swiss breast centers.

METHODS

A co-creative approach was employed. Breast cancer survivors and health care professionals (total n = 81) participated in three workshops, an online rating, and a consensus conference. An iterative cycle (evidence, ideas, refining, rating, and synthesis) guided the adaptation process.

RESULTS

Survivors involvement in the adaptation process allowed to tailor the self-management program to the psychosocial needs identified as the highest priority. New contents "Being a woman", "Breast cancer and my (working) life" and "My exercise" were added to the CTS. Program duration was expanded from 6 to 7 weeks. Transition to follow-up care was considered as the optimal time point for program integration into the clinical pathway.

CONCLUSION

The co-creative process may serve as a model in adapting supportive interventions for cancer. A subsequent pilot testing examined the feasibility and preliminary efficacy.

PRACTICE IMPLICATIONS

Combining expertise of health care professionals and patients to co-create a peer-led breast cancer self-management program may enhance acceptability and adoption.

摘要

目的

以同伴为主导的癌症康复与生存项目(CTS)已证明可改善癌症幸存者的健康结果。我们描述了一种共同创造的过程,用于改编瑞士的乳腺癌幸存者的 CTS 项目,并将该项目整合到瑞士乳腺癌中心的临床路径中。

方法

采用共同创造的方法。81 名乳腺癌幸存者和医疗保健专业人员参加了三个研讨会、在线评估和共识会议。一个迭代周期(证据、想法、细化、评估和综合)指导了改编过程。

结果

幸存者参与改编过程使自我管理计划能够满足确定的最高优先级的心理社会需求。新增了“作为女性”、“乳腺癌和我的(工作)生活”和“我的运动”等新内容。该项目的时长从 6 周延长至 7 周。将过渡到后续护理视为将该项目整合到临床路径中的最佳时间点。

结论

共同创造过程可作为改编癌症支持性干预措施的模型。随后的试点测试检验了其可行性和初步效果。

实践意义

结合医疗保健专业人员和患者的专业知识,共同创造一种以同伴为主导的乳腺癌自我管理项目,可以提高其可接受性和采用率。

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