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癌症姑息治疗环境中协作的交互和组织决定因素的定性探讨:来自家庭成员、医疗保健专业人员和关键知情人的观点。

A qualitative exploration of interactional and organizational determinants of collaboration in cancer palliative care settings: Family members', health care professionals' and key informants' perspectives.

机构信息

Person-centered Healthcare & Health Communication, Swiss Paraplegic Research, Nottwil, Canton of Lucerne, Switzerland.

Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Canton of Lucerne, Switzerland.

出版信息

PLoS One. 2021 Oct 6;16(10):e0256965. doi: 10.1371/journal.pone.0256965. eCollection 2021.

Abstract

As life expectancy has increased, a growing number of people experience conditions, including cancers, that carry complex health and social needs. Palliative care services have the potential to address these needs but face significant obstacles. One major obstacle is suboptimal interprofessional collaboration. This study's goal was an in-depth exploration of interactional and organizational barriers and supports of collaboration in palliative care in Switzerland. We sought the perspectives of health care professionals, patients' family members and leaders and experts in oncology/palliative care delivery (key informants) through interviews and focus groups with fifty HPs and key informants and ten patients' family members. Qualitative analyses of interviews and focus groups used framework analysis. We identified three major themes of interaction: personal characteristics, communication, and connectedness with other health care professionals; and three major organizational themes: service characteristics, standardized communication and processes, and service coordination and promotion. Based on our findings, we recommend that health care professionals consider strategies to increase their collaboration and communication skills and opportunities to interact. We advocate the implementation of methods for coordinating services, standardization of consultation/referral procedures and communication between health care professionals, and the promotion of underutilized services to foster successful, sustainable collaboration.

摘要

随着预期寿命的延长,越来越多的人经历各种疾病,包括癌症,这些疾病需要复杂的医疗和社会需求。姑息治疗服务有潜力满足这些需求,但面临着重大障碍。一个主要障碍是专业间协作不佳。本研究的目的是深入探讨瑞士姑息治疗中协作的互动和组织障碍及支持因素。我们通过访谈和焦点小组,从医疗保健专业人员、患者家属和肿瘤学/姑息治疗服务提供方面的领导和专家(关键知情人)那里,寻求他们的观点。对访谈和焦点小组的定性分析采用了框架分析。我们确定了三个主要的互动主题:个人特征、沟通和与其他医疗保健专业人员的联系;以及三个主要的组织主题:服务特征、标准化沟通和流程以及服务协调和推广。基于我们的发现,我们建议医疗保健专业人员考虑增加协作和沟通技巧的策略,以及增加互动的机会。我们主张实施协调服务、规范咨询/转介程序以及促进医疗保健专业人员之间的沟通的方法,并推广利用不足的服务,以促进成功、可持续的协作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f22a/8494323/bd6ab64bf0fa/pone.0256965.g001.jpg

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