Waters Martine, de Jersey Susan, Brebner Neil, Reeves Marina Michelle
Central Integrated Regional Cancer Care Services, Queensland Health, Brisbane, Queensland, Australia.
Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
Aust J Rural Health. 2023 Feb;31(1):114-123. doi: 10.1111/ajr.12925. Epub 2022 Oct 6.
To describe: (1) the type and frequency of interventions undertaken by regional cancer specialist Allied Health Professionals (AHPs); and (2) regional generalist AHPs' exposure and confidence in undertaking these interventions.
Multiphase, observational study including a prospective study and a cross-sectional survey.
Two regional Queensland Hospitals.
Cancer specialist AHPs (n = 13 in a prospective study; n = 7 in a cross-sectional survey) and generalist AHPs (n = 36 in a cross-sectional survey), across six disciplines from two regional hospitals and cancer services.
Phase 1: Frequency of cancer care AHP occasions of service and interventions. Phase 2: Current practice in cancer care AHP interventions; confidence; access to training, professional development and mentorship; barriers to working in cancer care, among cancer care and generalist AHPs.
Over 10-months, cancer care AHPs collectively delivered 12 393 interventions across 8850 occasions of service. Only four cancer care interventions were exclusively or predominantly carried out by cancer care AHPs-laryngectomy pre-operative counselling, laryngectomy rehabilitation and tracheostomy management (speech pathology) and lymphoedema management (physiotherapy). Generalist AHPs reported slightly lower confidence across all tasks if asked to carry out known interventions in a cancer setting compared with familiar settings. The primary perceived barrier to working in cancer care was lack of skills/experience/training reported by most CC AHPs, generalist Physiotherapists and Speech Pathologists, but not other generalist AHPs.
There was a significant overlap in interventions undertaken in the cancer care and generalist setting for AHPs. Appropriate on-boarding to contextualise interventions to cancer care is recommended to overcome reported lower confidence.
描述:(1)地区癌症专科专职医疗人员(AHPs)所采取干预措施的类型和频率;(2)地区全科AHPs在实施这些干预措施方面的接触情况和信心。
多阶段观察性研究,包括前瞻性研究和横断面调查。
昆士兰州的两家地区医院。
来自两家地区医院和癌症服务机构六个学科的癌症专科AHPs(前瞻性研究中n = 13;横断面调查中n = 7)和全科AHPs(横断面调查中n = 36)。
第1阶段:癌症护理AHPs的服务时机和干预措施的频率。第2阶段:癌症护理AHPs干预措施的当前实践;信心;获得培训、专业发展和指导的机会;癌症护理人员和全科AHPs在癌症护理工作中的障碍。
在10个月的时间里,癌症护理AHPs在8850次服务时机中总共提供了12393次干预措施。只有四项癌症护理干预措施完全或主要由癌症护理AHPs实施——喉切除术术前咨询、喉切除术康复和气管造口管理(言语病理学)以及淋巴水肿管理(物理治疗)。与熟悉的环境相比,如果被要求在癌症环境中实施已知干预措施,全科AHPs在所有任务中的信心略低。大多数癌症护理AHPs、全科物理治疗师和言语病理学家报告称,在癌症护理工作中的主要障碍是缺乏技能/经验/培训,但其他全科AHPs并非如此。
AHPs在癌症护理和全科环境中实施的干预措施存在显著重叠。建议进行适当的入职培训,使干预措施与癌症护理相关,以克服报告中较低的信心。