患有合并症的肺癌患者对跨医疗保健部门的多专业协作式护理的看法：定性访谈研究。
What patients with lung cancer with comorbidity tell us about interprofessional collaborative care across healthcare sectors: qualitative interview study.
机构信息
Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany
Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany.
出版信息
BMJ Open. 2020 Aug 4;10(8):e036495. doi: 10.1136/bmjopen-2019-036495.
BACKGROUND
Patients with lung cancer with comorbidity often require treatment and care by different health professionals, in different settings and at different points in time during the course of the disease. In order to organise and coordinate healthcare efficiently, effective information exchange and collaboration between all involved care providers are required. The aim of this study was to assess the views of patients with advanced lung cancer with comorbidity regarding coordination of treatment and care across healthcare sectors.
METHODS
This qualitative study, as part of the main study, The Heidelberg Milestones Communication Approach, used face-to-face guide-based semistructured interviews with patients with advanced lung cancer and their informal caregivers to explore cross-sectoral information exchange and collaboration in Germany. All generated data were audio-recorded, pseudonymised and transcribed verbatim. Data analysis was performed using qualitative content analysis to structure data into themes and subthemes. All data were managed and organised in MAXQDA.
RESULTS
In 15 interviews, participants reported that cross-sectoral collaboration functioned well, if treatments occurred as planned. However, treatment gaps were experienced, especially regarding medication and regimen. As a result, participants felt insecure and obliged to take responsibility for the coordination of healthcare. Patients reported to be in favour of an active patient role but felt that healthcare coordination should still be a responsibility of a care provider. A more intensive information exchange, potentially by using an electronic platform, was expected to strengthen cross-sectoral collaboration.
CONCLUSION
Patients with lung cancer are uncertain about their role in the coordination of treatment and care across healthcare sectors. Healthcare providers should be more aware of care recipients' willingness of taking on a more active role in healthcare coordination.
TRIAL REGISTRATION NUMBER
DRKS00013469.
背景
患有合并症的肺癌患者通常需要不同的卫生专业人员在不同的环境中在疾病过程中的不同时间进行治疗和护理。为了有效地组织和协调医疗保健，所有相关护理提供者之间需要进行有效的信息交流和协作。本研究的目的是评估患有合并症的晚期肺癌患者对跨医疗保健部门治疗和护理协调的看法。
方法
作为主要研究的一部分，这项定性研究使用面对面的基于指南的半结构化访谈，对患有晚期肺癌的患者及其非正式照顾者进行了访谈，以探讨德国跨部门的信息交流和协作。所有生成的数据均进行了录音、匿名处理和逐字转录。使用定性内容分析对数据进行分析，将数据构建为主题和子主题。所有数据均在 MAXQDA 中进行管理和组织。
结果
在 15 次访谈中，参与者报告说，如果治疗按计划进行，跨部门的协作运作良好。然而，他们经历了治疗间隙，特别是在药物和方案方面。因此，参与者感到不安，有责任协调医疗保健。患者报告支持积极的患者角色，但认为医疗保健协调仍然是护理提供者的责任。更密集的信息交流，可能通过使用电子平台，有望加强跨部门的协作。
结论
肺癌患者对他们在跨医疗保健部门治疗和护理协调中的角色不确定。医疗保健提供者应该更加意识到护理接受者愿意在医疗保健协调中发挥更积极的作用。
试验注册号
DRKS00013469。
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