Center for Evidence-Based Healthcare, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany.
Skin Cancer Center at the University Cancer Center and National Center for Tumor Diseases, Department of Dermatology, University Hospital Carl Gustav Carus and Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany.
Curr Oncol. 2022 Apr 9;29(4):2583-2598. doi: 10.3390/curroncol29040212.
Skin cancer is one of the most common cancers worldwide and the number of patients is steadily increasing. In skin cancer care, greater interdisciplinary cooperation is required for prevention, early detection, and new complex systemic therapies. However, the implementation of innovative medical care is a major challenge, especially for rural regions with an older than average, multimorbid population, with limited mobility, that are long distances from medical facilities. Solutions are necessary to ensure comprehensive oncological care in rural regions. The aim of this study was to identify indicators to establish a regional care network for integrated skin cancer care. To capture the perspectives of different stakeholder groups, we conducted two focus groups with twenty skin cancer patients and their relatives, a workshop with eight physicians, and three semi-structured interviews with health insurance company representatives. Qualitative data were recorded, transcribed, and analyzed following Mayring's content analysis methods. We generated ten categories based on the reported optimization potentials; five categories were assigned to all three stakeholder groups: Prevention and early diagnosis, accessibility of physicians/clinics, physicians' resources, care provider's responsibilities, and information exchange. The results indicate the need for stronger integration of care in the region. They provide the basis for regional networking as, for example, the conception of treatment pathways or telemedicine with the aim to improve a comprehensive skin cancer care. Our study should raise awareness and postulate as a demand that all patients receive guideline-based therapy, regardless of where they live.
皮肤癌是全球最常见的癌症之一，患者人数正在稳步增加。在皮肤癌的治疗中，需要加强预防、早期发现和新的复杂系统治疗方面的跨学科合作。然而，实施创新医疗是一个重大挑战，特别是对于那些人口老龄化、多病共存、行动不便、距离医疗机构较远的农村地区。需要找到解决方案来确保农村地区的全面肿瘤护理。本研究的目的是确定建立综合皮肤癌护理区域护理网络的指标。为了了解不同利益相关者群体的观点，我们对 20 名皮肤癌患者及其亲属进行了两次焦点小组讨论，对 8 名医生进行了一次研讨会，对 3 名医疗保险公司代表进行了三次半结构化访谈。按照梅林的内容分析法记录、转录和分析了定性数据。我们根据报告的优化潜力生成了十个类别；五个类别被分配给所有三个利益相关者群体：预防和早期诊断、医生/诊所的可及性、医生资源、护理提供者的责任和信息交流。结果表明，该地区需要更紧密的护理整合。它们为区域网络提供了基础，例如，治疗途径的概念或远程医疗旨在改善全面的皮肤癌护理。我们的研究应该提高认识，并假设所有患者都应接受基于指南的治疗，无论他们居住在哪里。
