Département de gestion, d'évaluation et de politique de santé, École de santé publique de l'Université de Montréal, Montreal, Canada.
Centre de recherche en santé publique, CIUSSS du Centre-Sud-de-l'Île-de-Montréal et Université de Montréal, Montreal, Canada.
BMC Health Serv Res. 2020 Nov 12;20(1):1039. doi: 10.1186/s12913-020-05882-3.
Providing care to cancer patients is associated with a substantial psychological and emotional load on oncology workers. The purpose of this project is to co-construct, implement and assess multidimensional intervention continuums that contribute to developing the resilience of interdisciplinary cancer care teams and thereby reduce the burden associated with mental health problems. The project is based on resources theories and theories of empowerment.
The study will involve cancer care teams at four institutions and will use a mixed-model design. It will be organized into three components: (1) Intervention development. Rather than impose a single way of doing things, the project will take a participatory approach involving a variety of mechanisms (workshops, discussion forums, surveys, observations) to develop interventions that take into account the specific contexts of each of the four participating institutions. (2) Intervention implementation and assessment. The purpose of this component is to implement the four interventions developed in the preceding component, assess their effects and whether they are cost effective. A longitudinal quasi-experimental design will be used. Intervention monitoring will extend over 12 months. The effects will be assessed by means of generalized estimating equation regressions. A cost-benefit analysis will be performed to assess the cost-effectiveness of the interventions, taking an institutional perspective (costs and benefits associated with the intervention). (3) Analysis of co-construction and implementation process. The purpose of this component is to (1) describe and assess the approaches used to engage stakeholders in the co-construction and implementation process; (2) identify the factors that have fostered or impeded the co-construction, implementation and long-term sustainability of the interventions. The proposed design is a longitudinal multiple case study.
In the four participating institutions, the project will provide an opportunity to develop new abilities that will strengthen team resilience and create more suitable work environments. Beyond these institutions, the project will generate a variety of resources (e.g.: work situation analysis tools; method of operationalizing the intervention co-development process; communications tools; assessment tools) that other oncology teams will be able to adapt and deploy elsewhere.
为癌症患者提供护理会给肿瘤学工作者带来相当大的心理和情绪负担。本项目旨在共同构建、实施和评估多维干预连续体，以培养跨学科癌症护理团队的适应力，从而减轻与心理健康问题相关的负担。该项目基于资源理论和赋权理论。
该研究将涉及四家机构的癌症护理团队，并将采用混合模型设计。它将分为三个部分：（1）干预措施的制定。该项目将采取参与式方法，而不是强加单一的做事方式，通过各种机制（研讨会、讨论论坛、调查、观察）来制定干预措施，考虑到四个参与机构各自的具体情况。（2）干预措施的实施和评估。本部分的目的是实施前一部分中制定的四项干预措施，评估其效果和成本效益。将采用纵向准实验设计。干预监测将持续 12 个月。效果将通过广义估计方程回归进行评估。将进行成本效益分析，从机构角度评估干预措施的成本效益（与干预相关的成本和收益）。（3）共同构建和实施过程的分析。本部分的目的是：（1）描述和评估用于让利益攸关方参与共同构建和实施过程的方法；（2）确定促进或阻碍干预措施的共同构建、实施和长期可持续性的因素。拟议的设计是一个纵向多案例研究。
在参与的四个机构中，该项目将为发展新能力提供机会，这些能力将增强团队的适应力并创造更合适的工作环境。除了这些机构之外，该项目还将产生各种资源（例如：工作情况分析工具；干预共同开发过程的实施方法；沟通工具；评估工具），其他肿瘤学团队将能够在其他地方进行改编和部署。
