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在加拿大照顾癌症老年患者:来自社区医护提供者和癌症护理盟友的观点。

Caring for older adults with cancer in Canada: Views from healthcare providers and cancer care allies in the community.

机构信息

Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.

School of Nursing, University of British Columbia, Vancouver, BC, Canada.

出版信息

Support Care Cancer. 2024 Feb 15;32(3):157. doi: 10.1007/s00520-023-08303-3.

Abstract

BACKGROUND

Cancer is common and disproportionately impacts older adults. Moreover, cancer care of older adults is complex, and the current Canadian cancer care system struggles to address all of the dimensions. In this project, our goal was to understand the barriers and facilitators to caring for older adults with cancer from perspectives of healthcare professionals and cancer care allies, which included community groups, seniors' centers, and other community-based supports.

METHODS

In collaboration with a patient advisory board, we conducted focus groups and interviews with multiple local healthcare professionals and cancer care allies in British Columbia, Canada. We used a descriptive qualitative approach and conducted a thematic analysis using NVivo software.

RESULTS

A total of 71 participants of various disciplines and cancer care allies participated. They identified both individual and system-level barriers. Priority system-level barriers for older adults included space and staffing constraints and disconnections within healthcare systems, and between healthcare practitioners and cancer care allies. Individual-level barriers relate to the complex health states of older adults, caregiver/support person needs, and the needs of an increasingly diverse population where English may not be a first or preferable language.

CONCLUSIONS

This study identified key barriers and facilitators that demonstrate aligned priorities among a diverse group of healthcare practitioners and cancer care allies. In conjunction with perspectives from patients and caregivers, these findings will inform future improvements in cancer care. Namely, we emphasize the importance of connections among health systems and community networks, given the outpatient nature of cancer care and the needs of older adults.

摘要

背景

癌症很常见,且在老年人中发病率不成比例地更高。此外,老年人癌症护理非常复杂,而当前加拿大癌症护理系统在解决所有问题方面都面临困难。在这个项目中,我们的目标是从医疗保健专业人员和癌症护理盟友(包括社区团体、老年人中心和其他社区支持)的角度了解照顾老年癌症患者的障碍和促进因素。

方法

我们与患者咨询委员会合作,在加拿大不列颠哥伦比亚省对多位当地医疗保健专业人员和癌症护理盟友进行了焦点小组和访谈。我们采用描述性定性方法,并使用 NVivo 软件进行主题分析。

结果

共有来自不同学科和癌症护理盟友的 71 名参与者参加了研究。他们确定了个人和系统层面的障碍。老年患者的优先系统层面障碍包括空间和人员配备限制以及医疗保健系统内部以及医疗保健从业者与癌症护理盟友之间的脱节。个人层面的障碍与老年人复杂的健康状况、照顾者/支持人员的需求以及越来越多样化的人群有关,他们可能英语不是第一语言或首选语言。

结论

本研究确定了关键障碍和促进因素,这些因素在不同医疗保健从业者和癌症护理盟友中表现出一致的优先事项。结合患者和护理人员的观点,这些发现将为未来改善癌症护理提供信息。具体来说,鉴于癌症护理的门诊性质和老年人的需求,我们强调了医疗系统和社区网络之间联系的重要性。

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