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南非林波波省公共卫生机构中获得肿瘤服务以实现有效癌症护理的障碍:一项定性研究。

Barriers to Accessing Oncology Services for Effective Cancer Care in the Public Health Institutions in Limpopo Province, South Africa: A Qualitative Study.

作者信息

Ramutumbu Neo Jacqueline, Ramathuba Dorah Ursula, Maputle Maria Sonto

机构信息

Department of Advanced Nursing Science, Faulty of Health Sciences, Main Campus, University of Venda, Thohoyandou 0950, South Africa.

出版信息

Nurs Rep. 2023 Jul 12;13(3):956-968. doi: 10.3390/nursrep13030084.

Abstract

It is estimated that by 2030, 24 million people worldwide will develop cancer, and 13 million will die annually, with 75% of deaths in low- and middle-income countries. The management and effective control of care have not been fully achieved due to a lack of material and human resources exacerbated by poor governance and co-ordination of the services. The study aimed to explore barriers to accessing oncology services for effective cancer care in the public health institutions in Limpopo province. The study was conducted in the five district hospitals in Limpopo province. A qualitative exploratory descriptive and contextual approach was used to collect data that employed focus group discussions amongst healthcare professionals in different disciplines. Non-probability purposive sampling was used to sample participants from various sections contributing to oncology care. Five focus group discussions were conducted at the selected hospitals. The data were analysed using the eight steps of Tesch's method. The findings revealed that Limpopo province has a shortage of high-technology medical equipment, poor coordination, and a lack of oncological and allied expertise. Governments should ensure that patients receive the care required as stated in the constitution to navigate cancer care pathways to improve patient health outcomes, particularly in rural areas where care is fragmented and poorly financed. Recommendations to support oncology patients involve psychosocial work and palliative care of the multidisciplinary teams to be put forward. The identified barriers regarding oncology care may contribute to changing the departments' outlook and effective functioning by including interdisciplinary oncology teams at all levels of care.

摘要

据估计,到2030年,全球将有2400万人患癌症,每年将有1300万人死亡,其中75%的死亡发生在低收入和中等收入国家。由于治理不善和服务协调不力导致缺乏物质和人力资源,护理的管理和有效控制尚未完全实现。该研究旨在探索林波波省公共卫生机构中获得肿瘤服务以实现有效癌症护理的障碍。该研究在林波波省的五家区级医院进行。采用定性探索性描述性和情境性方法收集数据,该方法在不同学科的医疗专业人员中进行焦点小组讨论。采用非概率目的抽样从参与肿瘤护理的各个部门抽取参与者。在选定的医院进行了五次焦点小组讨论。使用泰施方法的八个步骤对数据进行了分析。研究结果显示,林波波省高科技医疗设备短缺、协调不力,且缺乏肿瘤学及相关专业知识。政府应确保患者获得宪法规定的所需护理,以打通癌症护理路径,改善患者健康状况,尤其是在护理分散且资金不足的农村地区。支持肿瘤患者的建议包括提出多学科团队的心理社会工作和姑息治疗。确定的肿瘤护理障碍可能有助于通过在各级护理中纳入跨学科肿瘤团队来改变各部门的面貌和有效运作。

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