从乳腺护理护士那里获得护理的机会存在潜在的不平等：一项定性研究报告了澳大利亚转移性乳腺癌女性的经历和观点。
Potential inequities in availability of care from breast care nurses: a qualitative study reporting the experiences and perspectives of women with metastatic breast cancer in Australia.
机构信息
The Daffodil Centre, University of Sydney a Joint Venture With Cancer Council NSW, Sydney, NSW, Australia.
University of Sydney, Camperdown NSW 2050, Syndey, Australia.
出版信息
BMC Health Serv Res. 2022 Jul 22;22(1):942. doi: 10.1186/s12913-022-08269-8.
BACKGROUND
International consensus guidelines recommend patients with metastatic breast cancer have access to a nurse experienced in the treatment of metastatic breast cancer. This study aimed to explore women's experiences of supportive care from breast care nurses, including their perspectives on the role breast care nurses currently play in providing support to people with metastatic breast cancer.
METHODS
Multiple semi-structured qualitative interviews with 38 women with metastatic breast cancer in Australia. Data relating to nursing care were extracted and analysed using thematic analysis.
RESULTS
Three themes were identified: (1) feeling that supportive care needs are unrecognised; (2) confusion about role and relevance of breast care nurse to those with metastatic breast cancer; (3) care from metastatic breast care nurses (when available) was appreciated, valued and beneficial. Participants' experiences differed in relation to ease of access to, amount of contact with, and level of care provided by breast care nurses. Contact and care ranged from little or none to comprehensive and ongoing. A key system-level challenge was that the diversity of diagnostic and treatment pathways for metastatic breast cancer meant that no systematic means existed to support routine or regular contact between breast care nurses and participants. Participants who did report having access to a specialised metastatic breast care nurse placed considerable value on the care received. For these participants, care from the breast care nurse extended and complemented care from the oncologist and included much needed psychosocial and practical support. For these participants, the breast care nurse assumed the role of key contact and care coordinator and was valued for their availability, accessibility and responsiveness. High levels of trust developed between patient and breast care nurse.
CONCLUSIONS
Findings indicate that there may be gaps and inequities in supportive care in Australia for people diagnosed with metastatic breast cancer, a finding that supports earlier reports of limited access to breast care nurses for people with metastatic breast cancer in Australia. The specialised metastatic breast care nurse could potentially play a key role in addressing the high level of unmet supportive care needs and improve continuity of care for these patients.
背景
国际共识指南建议转移性乳腺癌患者能够获得具有转移性乳腺癌治疗经验的护士的支持。本研究旨在探讨女性从乳腺护理护士那里获得支持性护理的体验，包括她们对乳腺护理护士在为转移性乳腺癌患者提供支持方面目前所扮演角色的看法。
方法
对澳大利亚 38 名转移性乳腺癌女性进行了多次半结构化定性访谈。从护理护理中提取并分析与数据相关的主题分析。
结果
确定了三个主题：（1）感到支持性护理需求未得到认可；（2）对转移性乳腺癌患者的乳腺护理护士的角色和相关性感到困惑；（3）转移性乳腺癌护理护士（在可用时）的护理受到赞赏、重视和有益。参与者的经验因乳腺护理护士的易获得性、接触程度和提供的护理水平而异。接触和护理范围从很少或没有到全面和持续。一个关键的系统层面挑战是，转移性乳腺癌的诊断和治疗途径的多样性意味着不存在支持乳腺护理护士与参与者之间常规或定期接触的系统手段。确实报告能够获得专门的转移性乳腺癌护理护士的参与者非常重视所接受的护理。对于这些参与者，乳腺护理护士的护理扩展并补充了肿瘤医生的护理，包括急需的心理社会和实际支持。对于这些参与者，乳腺护理护士承担了主要联系人的角色，并因其可用性、可及性和响应能力而受到重视。患者和乳腺护理护士之间建立了高度的信任。
结论
研究结果表明，澳大利亚被诊断患有转移性乳腺癌的患者的支持性护理可能存在差距和不平等，这一发现支持了澳大利亚转移性乳腺癌患者获得乳腺护理护士机会有限的早期报告。专门的转移性乳腺癌护理护士可能在解决高水平的未满足支持性护理需求方面发挥关键作用，并改善这些患者的护理连续性。
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