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国家癌症研究所临床肿瘤学研究计划环境中的照护者参与实践:对推进该领域研究的启示。

Caregiver engagement practices in National Cancer Institute Clinical Oncology Research Program settings: Implications for research to advance the field.

机构信息

Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina.

Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina.

出版信息

Cancer. 2021 Feb 15;127(4):639-647. doi: 10.1002/cncr.33296. Epub 2020 Nov 2.

Abstract

BACKGROUND

Supportive care interventions have demonstrated benefits for both informal and/or family cancer caregivers and their patients, but uptake generally is poor. To the authors' knowledge, little is known regarding the availability of supportive care services in community oncology practices, as well as engagement practices to connect caregivers with these services.

METHODS

Questions from the National Cancer Institute Community Oncology Research Program (NCORP)'s 2017 Landscape Survey examined caregiver engagement practices (ie, caregiver identification, needs assessment, and supportive care service availability). Logistic regression was used to assess the relationship between the caregiver engagement outcomes and practice group characteristics.

RESULTS

A total of 204 practice groups responded to each of the primary outcome questions. Only 40.2% of practice groups endorsed having a process with which to systematically identify and document caregivers, although approximately 76% were routinely using assessment tools to identify caregiver needs and approximately 63.7% had supportive care services available to caregivers. Caregiver identification was more common in sites affiliated with a critical access hospital (odds ratio [OR], 2.44; P = .013), and assessments were less common in safety-net practices (OR, 0.41; P = .013). Supportive care services were more commonly available in the Western region of the United States, in practices with inpatient services (OR, 2.96; P = .012), and in practices affiliated with a critical access hospital (OR, 3.31; P = .010).

CONCLUSIONS

Although many practice groups provide supportive care services, fewer than one-half systematically identify and document informal cancer caregivers. Expanding fundamental engagement practices such as caregiver identification, assessment, and service provision will be critical to support recent calls to improve caregivers' well-being and skills to perform caregiving tasks.

摘要

背景

支持性护理干预措施已被证明对非正式和/或家庭癌症护理者及其患者都有益,但采用率普遍较低。据作者所知,对于社区肿瘤学实践中支持性护理服务的可用性,以及将护理者与这些服务联系起来的参与实践,知之甚少。

方法

国家癌症研究所社区肿瘤学研究计划(NCORP)2017 年景观调查的问题调查了护理者参与实践(即护理者识别、需求评估和支持性护理服务可用性)。使用逻辑回归评估护理者参与结果与实践群体特征之间的关系。

结果

共有 204 个实践群体对每个主要结果问题做出了回应。只有 40.2%的实践群体认可有一个系统地识别和记录护理者的流程,尽管大约 76%的实践群体通常使用评估工具来识别护理者的需求,大约 63.7%的实践群体有支持护理者的服务。在与基层医疗医院有附属关系的地点,护理者的识别更为常见(优势比[OR],2.44;P =.013),而在保障型实践中,评估则更为少见(OR,0.41;P =.013)。在美国西部地区、有住院服务的实践中(OR,2.96;P =.012),以及与基层医疗医院有附属关系的实践中(OR,3.31;P =.010),支持性护理服务更常见。

结论

尽管许多实践群体提供支持性护理服务,但不到一半的实践群体系统地识别和记录非正式癌症护理者。扩大基本参与实践,如护理者识别、评估和服务提供,对于支持最近改善护理者福祉和履行护理任务的技能的呼吁将至关重要。

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