Division of Pulmonary & Critical Care Medicine, Oregon Health & Science University OHSU, Portland, OR 97239, USA.
Center to Improve Veteran Involvement in Care, Veterans Affairs Portland Health Care System (VAPORHCS), Portland, OR 97239, USA.
Future Oncol. 2023 Jan;19(3):245-257. doi: 10.2217/fon-2022-0958. Epub 2023 Mar 28.
Palliative care integration improves quality of life among patients with lung cancer and their families. Despite these benefits, significant barriers persist and patients do not receive timely integration. This study sought to identify facilitators of and barriers to integration in lung cancer care. Semistructured qualitative interviews were conducted with palliative care and lung cancer clinicians and analyzed using traditional content analysis. 23 clinicians were interviewed from geographically dispersed hospitals within a national healthcare system. Palliative care integration improved over time, enhanced by several facilitators stratified at four levels (patient/clinician/hospital/organization). Most important among these was multidisciplinary care delivered in outpatient settings, fostering trust and relationships among clinicians which were pivotal to successful integration. Workforce shortages and limited use of primary palliative care among lung cancer clinicians need to be addressed for continued growth in the field. Relationships among clinicians are crucial to successful palliative care integration in lung cancer care.
姑息治疗的融入提高了肺癌患者及其家属的生活质量。尽管有这些好处，但仍存在显著的障碍，患者无法及时获得姑息治疗的融入。本研究旨在确定肺癌治疗中姑息治疗融入的促进因素和障碍。采用半结构式定性访谈的方法，对姑息治疗和肺癌临床医生进行了访谈，并采用传统的内容分析法进行了分析。在全国医疗保健系统中，从地理位置分散的医院采访了 23 名临床医生。姑息治疗的融入随着时间的推移而得到改善，这得益于四个层面（患者/临床医生/医院/组织）的几个促进因素。其中最重要的是在门诊环境中提供多学科护理，在临床医生中建立信任和关系，这对成功的融入至关重要。劳动力短缺和肺癌临床医生对初级姑息治疗的使用有限，这需要解决，以推动该领域的持续发展。临床医生之间的关系是肺癌姑息治疗成功融入的关键。
