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伊朗医疗体系中的医院到家庭过渡性癌症护理计划

Transitional Cancer Care Program from Hospital to Home in the Health Care System of Iran.

机构信息

Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Health Care Sciences, Palliative Research Center, Ersta Sköndal Bräcke University College, Campus Ersta, Stockholm, Sweden.

出版信息

Asian Pac J Cancer Prev. 2021 Apr 1;22(4):1231-1237. doi: 10.31557/APJCP.2021.22.4.1231.

Abstract

OBJECTIVES

Transitional care program refers to the health care continuity during transferring from one health care setting to another or to home. This is an essential program for cancer patients and reduces the risk of unnecessary hospital admissions as well as the complications of the disease. The aim of this study was to develop a transitional cancer care program from hospital to home in the health care system of Iran.

METHODS

This study is a health policy and system research. It was conducted in four stages from October 2019 to January 2020. The first stage was a qualitative study. The qualitative data were collected through semi-structured interviews with 24 participants and a focus group with eight experts. In the second stage, a literature review of transitional care models was carried out. The initial version of the transitional cancer care program was developed based on the qualitative results and the literature review in the third stage. The validity and feasibility of the program were assessed using the Delphi study in the fourth stage.

RESULTS

Six major categories were extracted from the qualitative results, consisting of "integrated services for the continuity of care", "holistic care", "care standardization", "the use of telemedicine", "the transparency of rules" and "the care process provision". Using these results and extracted the three common models of transitional care, the initial program was developed in three phases of pre-discharge, post-discharge, and transitional care with six protocols. The content validity of the program (98.7%) and its feasibility (95.8%) were approved by experts in the Delphi rounds.

CONCLUSIONS

It is necessary to revise hospitals' discharge program, and home health care center's plan for admission and delivering health care services for cancer patients. Also, a pilot program is necessary to find the system advantages and disadvantages.
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摘要

目的

过渡护理计划是指患者从一个医疗机构转移到另一个医疗机构或家庭时的医疗连续性。这是癌症患者的一项重要计划,可以降低不必要住院的风险以及疾病的并发症。本研究旨在为伊朗的医疗体系制定从医院到家庭的过渡癌症护理计划。

方法

这是一项卫生政策和系统研究。研究于 2019 年 10 月至 2020 年 1 月分四个阶段进行。第一阶段为定性研究。通过对 24 名参与者的半结构式访谈和 8 名专家的焦点小组收集定性数据。第二阶段对过渡护理模式进行文献回顾。第三阶段根据定性结果和文献回顾制定过渡性癌症护理计划的初始版本。第四阶段通过德尔菲研究评估该计划的有效性和可行性。

结果

从定性结果中提取了六个主要类别,包括“连续性护理的综合服务”、“整体护理”、“护理标准化”、“远程医疗的使用”、“规则透明度”和“护理过程提供”。使用这些结果并提取了三种常见的过渡护理模式,初步方案分为三个阶段:出院前、出院后和过渡护理,共六个方案。方案的内容有效性(98.7%)和可行性(95.8%)得到了德尔菲回合专家的认可。

结论

有必要修订医院的出院计划和家庭保健中心的入院和提供癌症患者医疗服务的计划。此外,还需要开展试点方案,以发现该系统的优势和劣势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba7b/8325128/8a174ea3bb7e/APJCP-22-1231-g001.jpg

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