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患有前列腺癌的男性参与基于监督小组的锻炼方案以对抗雄激素剥夺治疗相关副作用的临床路径的体验:一项定性焦点小组研究。

Experiences of Men With Prostate Cancer Participating in a Clinical Pathway With a Supervised Group-based Exercise Program to Combat Androgen Deprivation-Induced Side Effects: A Qualitative Focus Group Study.

机构信息

Department of Human Structure and Repair, Ghent University, Ghent, Belgium; Research Foundation - Flanders (FWO), Brussels, Belgium.

Department of Human Structure and Repair, Ghent University, Ghent, Belgium.

出版信息

Semin Oncol Nurs. 2023 Jun;39(3):151404. doi: 10.1016/j.soncn.2023.151404. Epub 2023 Mar 15.

Abstract

OBJECTIVES

A clinical pathway in daily practice improved implementation of evidence-based strategies for the management of androgen deprivation-induced side effects in men with prostate cancer. This study aimed to explore patients' expectations and reasons to start with the clinical pathway; explore patients' experiences and attitudes toward the pathway; and identify key pathway ingredients and examine patients' attitudes about a possible transition toward the home environment after a hospital-based pathway participation.

DATA SOURCES

Focus group interviews were conducted through purposeful sampling, consisting of former and current participants of the clinical pathway at Ghent University Hospital. Data was audiotaped and transcribed verbatim, coded in NVivo12, and thematically and inductively analyzed through constant comparisons.

CONCLUSION

Men with prostate cancer have positive experiences toward the use of a holistic multidisciplinary approach (ie, clinical pathway) to combat androgen deprivation therapy-induced side effects in practice. Patients identified several key ingredients of the pathway, such as peer support, physiotherapist involvement, and availability of a multidisciplinary team. Patients were, however, reluctant to continue the exercise component at home because of negative attitudes toward a public gym, practical issues, absence of known facilitators, and other priorities.

IMPLICATIONS FOR NURSING PRACTICE

Referral by a health care provider remains an important motivator for pathway participation. Peer support, physiotherapist involvement, and availability of a multidisciplinary team are crucial components of the clinical pathway and should be taken into account when developing and implementing similar pathways to increase program uptake in daily practice.

摘要

目的

临床路径在日常实践中的应用提高了雄激素剥夺治疗引起的前列腺癌男性副作用管理的循证策略的实施。本研究旨在探讨患者开始临床路径的期望和原因;探讨患者对该路径的体验和态度;并确定关键路径成分,并研究患者对基于医院的路径参与后向家庭环境过渡的可能态度。

资料来源

通过有目的的抽样进行了焦点小组访谈,参与者为根特大学医院临床路径的前参与者和现参与者。数据被录音并逐字转录,在 NVivo12 中进行编码,并通过不断比较进行主题和归纳分析。

结论

前列腺癌男性对使用整体多学科方法(即临床路径)在实践中对抗雄激素剥夺治疗引起的副作用有积极的体验。患者确定了路径的几个关键成分,如同伴支持、物理治疗师的参与以及多学科团队的可用性。然而,患者不愿意在家中继续进行锻炼,因为他们对公共健身房持负面态度、存在实际问题、缺乏已知的促进者以及其他优先事项。

对护理实践的意义

医疗保健提供者的推荐仍然是参与路径的重要动机。同伴支持、物理治疗师的参与以及多学科团队的可用性是临床路径的关键组成部分,在制定和实施类似的路径时应考虑这些因素,以增加日常实践中的方案参与度。

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