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为复发或难治性白血病和淋巴瘤患者提供决策支持中医生和护士角色的定性分析。

Qualitative Analysis of the Roles of Physicians and Nurses in Providing Decision Support to Patients With Relapsed or Refractory Leukemia and Lymphoma.

机构信息

Otakanomori Chirdren's Clinic, Chiba, Japan.

Department of Human Health Sciences, 12918Kyoto University, Kyoto, Japan.

出版信息

Cancer Control. 2022 Jan-Dec;29:10732748221131003. doi: 10.1177/10732748221131003.

Abstract

INTRODUCTION

This study examined the roles of hematologists and other professionals in providing decision support to patients with relapsed or refractory leukemia and lymphoma.

METHODS

This was a qualitative study using in-depth semi-structured interviews involving 11 hematologists in Japan.

RESULT

We identified 7 categories related to the roles of hematologists in providing direct decision support to patients: (1) preparing patients before informed consent, (2) selecting the information to convey, (3) choosing a method for conveying this information, (4) respecting the intentions of patients and their families, (5) directing decision-making and considering fairness, (6) considering the emotional aspects of patients and their families, and (7) providing support after discussing treatment options. We also identified the following 5 subcategories related to the roles of hematologists in multidisciplinary collaboration: (1) communicating with other professionals, (2) gathering information from them, (3) providing information to them, (4) managing the entire medical team, and (5) encouraging nurses to actively participate with patients throughout the decision-making process.

CONCLUSION

Through content analysis, the hematologist's direct role in decision-making was extracted as preparation and consideration in situations where information about decision-making is communicated, and emotional support after the information is communicated. In addition, active participation in discussions, sharing information about the patient's situation and relevant discussions, and emotional support as the hematologist's expected roles in other professions were extracted. The results therefore suggest that a multidisciplinary team is needed to share information and provide multidimensional support to patients.

摘要

简介

本研究探讨了血液科医生和其他专业人员在为复发或难治性白血病和淋巴瘤患者提供决策支持方面的作用。

方法

这是一项使用深入的半结构式访谈的定性研究,涉及日本的 11 名血液科医生。

结果

我们确定了与血液科医生在为患者提供直接决策支持方面的 7 个角色类别:(1)在知情同意前准备患者,(2)选择要传达的信息,(3)选择传达此信息的方法,(4)尊重患者及其家属的意愿,(5)指导决策并考虑公平性,(6)考虑患者及其家属的情绪方面,以及(7)在讨论治疗方案后提供支持。我们还确定了与血液科医生在多学科协作中的 5 个亚类别:(1)与其他专业人员沟通,(2)从他们那里收集信息,(3)向他们提供信息,(4)管理整个医疗团队,以及(5)鼓励护士在决策过程中积极与患者合作。

结论

通过内容分析,从传达决策信息的情况中提取出血液科医生在决策中的直接作用,即准备和考虑,以及传达信息后的情感支持。此外,还提取了在其他专业中积极参与讨论、分享患者情况和相关讨论信息以及提供情感支持作为血液科医生的预期角色。因此,结果表明需要多学科团队来共享信息并为患者提供多维支持。

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Barriers to Quality End-of-Life Care for Patients With Blood Cancers.血液癌症患者获得优质临终关怀的障碍。
J Clin Oncol. 2016 Sep 10;34(26):3126-32. doi: 10.1200/JCO.2016.67.8177. Epub 2016 Jul 11.

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