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有复杂和姑息治疗需求的儿童及其家庭的全科医疗经历:一项定性研究。

Experiences of general practice of children with complex and palliative care needs and their families: a qualitative study.

作者信息

Mitchell Sarah, Harding Stephanie, Samani Mohini, Slowther Anne-Marie, Coad Jane, Dale Jeremy

机构信息

Oncology and Metabolism, The University of Sheffield, Sheffield, UK

Warwick Medical School, University of Warwick, Coventry, UK.

出版信息

BMJ Open. 2021 Jan 6;11(1):e041476. doi: 10.1136/bmjopen-2020-041476.

Abstract

OBJECTIVES

To investigate the views and experiences of general practice of children with life-limiting and life-threatening conditions, and their family members, through secondary analysis of a qualitative serial interview study. Thematic analysis was conducted on all interview data relating to experiences of primary care.

SETTING

West Midlands, UK.

PARTICIPANTS

A total of 31 participants (10 children with life-limiting and life-threatening conditions and 21 family members) from 14 families.

STUDY DESIGN AND SETTING

Secondary thematic analysis of qualitative interview data from a study carried out in the West Midlands, UK.

METHOD

41 serial interviews with 31 participants from 14 families: 10 children aged 5-18 years with life-limiting and life-threatening conditions, and 21 of their family members.

RESULTS

Three key themes emerged: (1) poor experiences of general practice cause children and families to feel isolated, (2) children and families value support from general practice, and (3) there are practical ways through which general practice has the potential to provide important aspects of care. Children and families reported benefits from fostering their relationship with their general practice in order to access important aspects of care, including the assessment and management of acute illness, chronic disease and medication reviews, and holistic support.

CONCLUSION

Children with life-limiting and life-threatening conditions and their families value the involvement of general practice in the care, alongside their paediatric specialists. Ways of developing and providing such support as part of an integrated system of care need to be developed.

摘要

目的

通过对一项定性系列访谈研究的二次分析,调查患有危及生命和生命受限疾病的儿童及其家庭成员对全科医疗的看法和体验。对所有与初级保健体验相关的访谈数据进行了主题分析。

背景

英国西米德兰兹郡。

参与者

来自14个家庭的31名参与者(10名患有危及生命和生命受限疾病的儿童以及21名家庭成员)。

研究设计与背景

对在英国西米德兰兹郡开展的一项研究中的定性访谈数据进行二次主题分析。

方法

对来自14个家庭的31名参与者进行了41次系列访谈:10名年龄在5至18岁之间患有危及生命和生命受限疾病的儿童及其21名家庭成员。

结果

出现了三个关键主题:(1)全科医疗的不良体验导致儿童和家庭感到孤立,(2)儿童和家庭重视全科医疗的支持,(3)全科医疗有切实可行的方法来提供重要的护理方面。儿童和家庭报告称,通过加强与全科医疗的关系以获得重要的护理方面有诸多益处,包括急性疾病、慢性病的评估与管理、药物审查以及整体支持。

结论

患有危及生命和生命受限疾病的儿童及其家庭重视全科医疗与儿科专家一起参与护理。需要探索作为综合护理系统一部分来发展和提供此类支持的方式。

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GPs and paediatric oncology palliative care: a Q methodological study.全科医生和儿科肿瘤舒缓治疗:一项 Q 方法学研究。
BMJ Support Palliat Care. 2020 Jun;10(2):e11. doi: 10.1136/bmjspcare-2015-000852. Epub 2017 Apr 21.

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