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[开发一种筛查工作流程以识别跨学科肿瘤日间诊所中的患者需求]

[Development of a screening workflow to identify patient needs in an interdisciplinary oncological day clinic].

作者信息

Windschüttl Sandra, Pukrop Tobias, Herrmann Anne, Lindberg-Scharf Patricia, Heudobler Daniel, Herr Wolfgang, Andreesen Reinhard, Klinkhammer-Schalke Monika, Koller Michael

机构信息

Klinik und Poliklinik für Innere Medizin III - Hämatologie und Internistische Onkologie, Universitätsklinikum Regensburg, Regensburg, Deutschland.

Klinik und Poliklinik für Innere Medizin III - Hämatologie und Internistische Onkologie, Universitätsklinikum Regensburg, Regensburg, Deutschland.

出版信息

Z Evid Fortbild Qual Gesundhwes. 2021 Jun;163:30-37. doi: 10.1016/j.zefq.2021.04.004. Epub 2021 May 21.

Abstract

INTRODUCTION

The diagnosis of cancer leads to high levels of emotional distress in many patients. Quality of life is an important therapeutic goal in this context. A quality-of-life guide was implemented in the oncological day clinic (ICT) at the University Hospital of Regensburg (UKR) in order to individually support outpatients, help them with their questions and needs and improve their quality of life.

METHODS

A screening tool is necessary for the structured assessment of quality of life/needs in the routine of tumor therapy and follow-up. As part of a mixed-methods study, focus groups with health professionals/patients were organized to specify the needs of cancer patients. On this basis, the literature was searched for questionnaires covering these needs in order to adapt an ICT-specific questionnaire and integrate it with the help of a workflow.

RESULTS

A total of 333 individual aspects were brought up by the participants in focus groups on the needs of cancer patients in various phases of treatment/with various tumor entities. Since none of the questionnaires identified in the literature met our requirements, a new screening tool containing elements from different standardized forms and the results of the focus groups was developed and a new workflow created to integrate the questionnaire into the ICT routine.

DISCUSSION

By interviewing health experts from different areas and patients with different tumor entities, the needs of cancer patients over different stages of the disease and additional possible differences between the cancer entities were identified and recorded. Through the implementation of a quality-of-life guide in the ICT, a structured assessment of the quality of life and an analysis of patient needs can take place with the help of the screening. A workflow was created to integrate screening into routine care. In addition, the questionnaire was designed in such a way that it can be used repeatedly at various points in time. In order to cover important stages in the course of therapy and to determine how patient needs change over the course, patients should be asked to complete the questionnaire several times after specified time intervals.

CONCLUSION

The questionnaire is intended to assess the needs of cancer patients receiving outpatient treatment in a structured manner. Now it needs to be explored how the new screening tool and workflow interact and perform in clinical practice and how they help to improve patients' quality of life. It is also interesting to analyze which patients accept the advice offered by the quality-of-life guide and which needs are expressed most frequently.

摘要

引言

癌症诊断会给许多患者带来高度的情绪困扰。在此背景下,生活质量是一个重要的治疗目标。雷根斯堡大学医院(UKR)的肿瘤日间门诊(ICT)实施了一项生活质量指南,以便为门诊患者提供个性化支持,帮助他们解决问题和满足需求,并提高他们的生活质量。

方法

在肿瘤治疗及随访过程中,需要一种筛查工具来对生活质量/需求进行结构化评估。作为一项混合方法研究的一部分,组织了卫生专业人员/患者焦点小组,以明确癌症患者的需求。在此基础上,检索文献以寻找涵盖这些需求的问卷,以便改编一份ICT专用问卷,并借助工作流程将其整合。

结果

焦点小组参与者共提出了333个关于癌症患者在不同治疗阶段/患有不同肿瘤类型时的需求的个体方面。由于文献中找到的问卷均不符合我们的要求,因此开发了一种新的筛查工具,该工具包含来自不同标准化表格的元素以及焦点小组的结果,并创建了一个新的工作流程,将问卷整合到ICT日常工作中。

讨论

通过采访不同领域的卫生专家和患有不同肿瘤类型的患者,确定并记录了癌症患者在疾病不同阶段的需求以及不同肿瘤类型之间可能存在的其他差异。通过在ICT中实施生活质量指南,可以借助筛查对生活质量进行结构化评估并分析患者需求。创建了一个工作流程,将筛查整合到常规护理中。此外,问卷的设计方式使其可以在不同时间点重复使用。为了涵盖治疗过程中的重要阶段并确定患者需求如何随病程变化,应要求患者在指定时间间隔后多次填写问卷。

结论

该问卷旨在以结构化方式评估接受门诊治疗的癌症患者的需求。现在需要探索新的筛查工具和工作流程在临床实践中如何相互作用和发挥作用,以及它们如何帮助提高患者的生活质量。分析哪些患者接受生活质量指南提供的建议以及哪些需求最常被表达也很有趣。

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