Cancer Division, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom.
J Adolesc Young Adult Oncol. 2021 Oct;10(5):503-511. doi: 10.1089/jayao.2020.0120. Epub 2021 Mar 10.
In England, specialist cancer services for adolescents and young adults (young people) aged 15-24 are provided in 13 specialist units, with additional care provided in child and adult cancer units in the region. As a result of specialization, health care professionals (HCPs) have refined their competence, to deliver holistic care that has become central to the culture of young people's cancer care. We sought to understand and describe how HCPs developed this competence. We conducted a multiple case study in four regions across England in 24 hospitals. Data were collected through observation of clinical areas, shadowing members of the multidisciplinary team, and semistructured interviews with young people. Data were analyzed thematically and triangulated to draw meaning applicable to a range of contexts. Young people ( = 29) and HCP ( = 41) across 24 different care settings were interviewed. Holistic competence enabled HCPs to deliver care that considered the age-specific needs of young people, including social, emotional, and psychological needs, in accordance with their life stage and psychosocial development. Development of holistic competence was facilitated by the following four factors: the environment, the experience continuum, enthusiasm, and education. The four factors facilitating holistic competence were interlinked. Working in a specialist/dedicated environment for young people increased HCPs' exposure to young people. This enabled them to become experienced in young people's cancer care, supported through education and training. Without frequent exposure to young people, HCPs were less able to achieve holistic competence, the impact of which was acutely felt by young people.
在英国，为 15-24 岁的青少年和年轻人（年轻人）提供了 13 个专业癌症服务单位，在该地区的儿童和成人癌症单位提供额外的护理。由于专业化，医疗保健专业人员（HCP）已经完善了他们的能力，以提供整体护理，这已成为年轻人癌症护理文化的核心。我们试图了解和描述 HCP 如何发展这种能力。我们在英格兰四个地区的 24 家医院进行了一项多案例研究。通过观察临床区域、跟踪多学科团队成员以及对年轻人进行半结构化访谈来收集数据。通过主题分析和三角测量对数据进行分析，以得出适用于各种情况的意义。在 24 个不同的护理环境中对 29 名年轻人和 41 名 HCP 进行了访谈。整体能力使 HCP 能够提供符合年轻人特定年龄需求的护理，包括社会、情感和心理需求，符合他们的生活阶段和心理社会发展。整体能力的发展是由以下四个因素促成的：环境、经验连续体、热情和教育。促进整体能力的四个因素是相互关联的。在专门为年轻人设立的环境中工作会增加 HCP 与年轻人的接触。这使他们能够在年轻人的癌症护理方面获得经验，并通过教育和培训得到支持。如果没有频繁接触年轻人，HCP 就不太能够实现整体能力，这对年轻人的影响是非常明显的。
