Wang Wenxia, Li Huanhuan, Li Yijing, Fang Shuyan, Zhang Shuang, Zhang Xu, Meng Xiangfei, Su Jianping, Sun Jiao
Basic Nursing Department, School of Nursing, Jilin University, Changchun, China.
J Clin Nurs. 2022 Nov;31(21-22):2985-2999. doi: 10.1111/jocn.16189. Epub 2022 Jan 5.
To systematically identify, synthesise and characterise the available qualitative evidence on the experience of adult colorectal cancer survivors with continuity of care led by different health professionals.
The limited evidence base for effective continuity of care led by different medical staff who assist colorectal cancer survivors with their unique survivorship care hampers the development of effective interventions. Synthesising the data on survivors' experience of care led by different health professionals is critical to develop such interventions.
A qualitative evidence synthesis using the Thomas and Harden method and the PRISMA 2020 checklist provided by the EQUATOR network were used.
PubMed, Web of Science, Embase, Cochrane, CINAHL and PsycINFO were searched through November 2020 for qualitative and mixed methods studies in English. JBI-QARI was used to undertake a quality review of the identified studies. The review findings were synthesised by a team of researchers, and the level of confidence was evaluated using GRADE-CERQual.
Eleven studies met the criteria for inclusion in the review. The identified analytical themes included experience of diversity, preference for health professionals and space for enhancement to facilitate improved medical care delivery. Colorectal cancer survivors report diverse experiences regarding continuity of care led by different providers. Specifically, they attach substantial importance to trusted relationships with providers that are closely associated with their overall care experience.
Effective communication and good rapport among stakeholders are cornerstones for addressing the complexity of ongoing care. Future interventions should include adjusting the percentage of care from different providers to deliver cost-effective and personalised continuity of care.
Synthesising data on survivors' experience facilitates the development of practical approaches to increase the quality of continuity of care and may also foster the integration of providers' advantages to enable more cost-effective intervention. The limited capacity of primary care providers may be enhanced by better cooperation and communication with specialists and by additional professional cancer-related training.
系统识别、综合并描述现有关于成年结直肠癌幸存者在不同医疗专业人员主导下的连续性护理体验的定性证据。
由不同医务人员为结直肠癌幸存者提供独特的生存护理，其有效连续性护理的证据基础有限，这阻碍了有效干预措施的发展。综合不同医疗专业人员主导的幸存者护理体验数据对于制定此类干预措施至关重要。
采用托马斯和哈登方法以及EQUATOR网络提供的PRISMA 2020清单进行定性证据综合。
截至2020年11月，在PubMed、科学网、Embase、Cochrane、CINAHL和PsycINFO中检索英文的定性和混合方法研究。使用JBI-QARI对纳入研究进行质量审查。研究结果由一组研究人员进行综合，并使用GRADE-CERQual评估可信度。
11项研究符合纳入审查的标准。确定的分析主题包括多样性体验、对医疗专业人员的偏好以及改进的空间，以促进改善医疗服务提供。结直肠癌幸存者报告了不同提供者主导的连续性护理的多样体验。具体而言，他们非常重视与提供者的信任关系，这与他们的整体护理体验密切相关。
利益相关者之间的有效沟通和良好关系是应对持续护理复杂性的基石。未来的干预措施应包括调整不同提供者的护理比例，以提供具有成本效益和个性化的连续性护理。
综合幸存者体验数据有助于制定提高连续性护理质量的实用方法，也可能促进整合提供者的优势，以实现更具成本效益的干预。通过与专科医生更好地合作与沟通以及额外的癌症相关专业培训，可以提高初级保健提供者的有限能力。
