Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Department of Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
BJU Int. 2023 Jul;132(1):47-55. doi: 10.1111/bju.15982. Epub 2023 Feb 22.
To explore patient experience of follow-up care after kidney cancer surgery and to develop recommendations for best practice.
We conducted two focus groups, including 14 participants with experience of kidney cancer follow-up after surgery, to elicit patient views on current follow-up care. Thematic analysis was used to identify unifying themes to describe the patient experience of follow-up, and the results were then used to develop a set of recommendations for best practice.
We identified six themes (feelings of abandonment; uncertainty about the plan; anxiety about appointments; variation in care; a need for information; and a need for emotional support) that described current patient experience and areas in which current care could be improved. In particular, while most of the participants felt that their physical needs had been met, many had struggled with unmet emotional needs and a lack of information and resources. This was especially noted in the period immediately following surgery, when feelings of abandonment were common, and around follow-up scans and routine appointments, which were a source of anxiety. Our participants also described concerns about the lack of consistency between different hospitals and centres around the United Kingdom, with differences in the content and quality of follow-up care. Based on the results, we developed a list of recommendations to address some of the challenges described through relatively minor changes to the care pathway.
We identified gaps and variability in current follow-up care after kidney cancer surgery, and have developed a set of recommendations that, if implemented, would improve the follow-up care experience for these patients.
探索肾癌手术后患者对随访护理的体验,并为最佳实践制定建议。
我们进行了两次焦点小组讨论,参与者为 14 名有肾癌手术后随访经验的患者,以了解患者对当前随访护理的看法。采用主题分析方法来确定统一的主题,以描述患者随访的体验,然后利用这些结果制定了一套最佳实践建议。
我们确定了六个主题(被遗弃的感觉;对计划的不确定性;对预约的焦虑;护理的变化;对信息的需求;以及对情感支持的需求),这些主题描述了当前患者的体验以及可以改进的当前护理领域。特别是,虽然大多数参与者认为他们的身体需求得到了满足,但许多人在情感需求未得到满足、缺乏信息和资源方面遇到了困难。这在手术后的立即时期尤为明显,当时被遗弃的感觉很普遍,而随访扫描和常规预约也会引起焦虑。我们的参与者还描述了对英国不同医院和中心之间缺乏一致性的担忧,包括随访护理的内容和质量存在差异。基于这些结果,我们提出了一系列建议,以通过对护理途径的一些微小改变来解决描述的一些挑战。
我们发现肾癌手术后的随访护理存在差距和变异性,并制定了一套建议,如果实施,将改善这些患者的随访护理体验。