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区域卫生服务中肺癌转诊途径的患者及护理人员体验:一项定性研究。

Patient and carer experiences of lung cancer referral pathway in a regional health service: a qualitative study.

作者信息

Otty Zulfiquer, Brown Amy, Larkins Sarah, Evans Rebecca, Sabesan Sabe

机构信息

Townsville Cancer Centre, Townsville University Hospital, Queensland, Townsville, Australia.

College of Medicine and Dentistry, James Cook University, Queensland, Townsville, Australia.

出版信息

Intern Med J. 2023 Nov;53(11):2016-2027. doi: 10.1111/imj.16022. Epub 2023 Mar 6.

Abstract

BACKGROUND

Lung cancer referral pathways aim to reduce delays and improve referral patterns of people with suspected lung cancer.

AIM

As part of implementing a lung cancer referral pathway at a regional Australian hospital, this study aimed to explore the experiences and perceptions of people with lung cancer and their carers.

METHODS

In-depth interviews were used to elicit data for thematic analysis in this cross-sectional descriptive qualitative study. Patients with newly diagnosed lung cancer and their carers at a regional academic cancer centre were invited to participate in interviews. Five interviews were conducted face-to-face, and 14 interviews were conducted by telephone (as per interviewee preference). Interviews were audiorecorded, transcribed and qualitatively analysed. Descriptive phrases were used to generate initial inductive codes and themes.

RESULTS

Nineteen participants approached agreed to take part in the study. Factors that positively impacted the care experience were good communication, timeliness and patient advocacy and support. Improper communication, long waiting times for investigations and appointments, uncertainty about the process and inconsistent advice from providers negatively impacted the care experience. Participants preferred face-to-face or video-linked consultations over telephone consultations.

CONCLUSIONS

Understanding the experiences of rural and regional patients and carers with the lung cancer referral pathway is important to improve quality of care. Implementing changes to the referral pathway to improve patient and carer experiences needs to be an ongoing quality improvement exercise.

摘要

背景

肺癌转诊途径旨在减少延误,并改善疑似肺癌患者的转诊模式。

目的

作为在澳大利亚一家地区医院实施肺癌转诊途径的一部分,本研究旨在探索肺癌患者及其护理人员的经历和看法。

方法

在这项横断面描述性定性研究中,采用深度访谈来获取数据进行主题分析。邀请了一家地区学术癌症中心新诊断为肺癌的患者及其护理人员参与访谈。进行了5次面对面访谈,14次电话访谈(根据受访者的偏好)。访谈进行了录音、转录并进行定性分析。使用描述性短语生成初始归纳代码和主题。

结果

19名被邀请的参与者同意参加该研究。对护理体验有积极影响的因素包括良好的沟通、及时性以及患者宣传和支持。沟通不当、检查和预约等待时间长、过程的不确定性以及提供者的建议不一致对护理体验产生了负面影响。参与者更喜欢面对面或视频链接咨询,而不是电话咨询。

结论

了解农村和地区患者及护理人员在肺癌转诊途径方面的经历对于提高护理质量很重要。对转诊途径进行变革以改善患者和护理人员的体验需要持续进行质量改进工作。

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