恶性脑肿瘤患者及其照护者的睡眠障碍管理障碍:医疗保健专业人员认知的定性分析。

Barriers to managing sleep disturbance in people with malignant brain tumours and their caregivers: a qualitative analysis of healthcare professionals' perception.

机构信息

South Western Sydney Clinical School, University of New South Wales, Liverpool, Australia.

IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Sydney, Australia.

出版信息

Support Care Cancer. 2021 Jul;29(7):3865-3876. doi: 10.1007/s00520-020-05970-4. Epub 2021 Jan 2.

Abstract

PURPOSE

This study explores healthcare professionals (HCPs)' perception and current management of sleep disturbance (SD) in people with malignant brain tumours and their caregivers. We aimed to identify barriers to effective management of SD in neuro-oncology care.

METHODS

We conducted semi-structured interviews with 11 HCPs involved in neuro-oncology care. The study was underpinned by the Capability Opportunity Motivation-Behaviour (COM-B) model within the Behavioural Change Wheel (BCW) guiding topic selection for the exploration of underlying processes of HCPs' behaviours and care decisions for SD management. Data were analysed thematically using a framework synthesis, and subsequently mapped onto the BCW to identify barriers for effective management and recommend potential interventions.

RESULTS

We identified four themes: HCPs' clinical opinions about SD, the current practice of SD management in neuro-oncology clinics, gaps in the current practice, and suggested areas for improvements. HCPs perceived SD as a prevalent yet secondary issue of low priority in neuro-oncology care. SD was unrecognised, and inadequately managed in usual clinical settings. Interventional options included modifying the use of corticosteroids or prescribing sedatives. When mapped onto the BCW, themes identified main barriers as a lack of awareness among HCPs about SD warranting care, due to the absence of screening tools and limited knowledge and resources for therapeutic interventions.

CONCLUSIONS

Multidisciplinary HCPs need training in the routine use of appropriate sleep assessment tools, and access to clear management pathways. More professional resources are needed to educate staff in implementing appropriate interventions for people with malignant brain tumours who are experiencing SD.

摘要

目的

本研究探讨了医疗保健专业人员(HCP)对恶性脑肿瘤患者及其照护者睡眠障碍(SD)的认知和当前管理情况。我们旨在确定神经肿瘤学护理中有效管理 SD 的障碍。

方法

我们对 11 名参与神经肿瘤学护理的 HCP 进行了半结构式访谈。该研究基于能力机会动机-行为(COM-B)模型,在行为改变车轮(BCW)的指导下,选择主题,以探索 HCP 行为和 SD 管理护理决策的潜在过程。使用框架综合法对数据进行了主题分析,随后将其映射到 BCW 上,以确定有效管理的障碍,并提出潜在的干预措施。

结果

我们确定了四个主题:HCP 对 SD 的临床意见、神经肿瘤学诊所中 SD 管理的当前实践、当前实践中的差距以及改进的建议领域。HCP 认为 SD 是神经肿瘤学护理中普遍存在但优先级较低的次要问题。SD 在常规临床环境中未被识别且管理不足。干预选项包括修改皮质类固醇的使用或开具镇静剂。将其映射到 BCW 上,主题确定了主要障碍,即 HCP 对需要护理的 SD 的认识不足,这是由于缺乏筛查工具以及治疗干预措施的知识和资源有限所致。

结论

多学科 HCP 需要接受常规使用适当睡眠评估工具的培训,并获得明确的管理途径。需要更多的专业资源来教育工作人员,以便对患有 SD 的恶性脑肿瘤患者实施适当的干预措施。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索