一项混合方法研究，评估了一种针对农村门诊乳腺手术患者的创新护理模式。
A mixed-method study evaluating an innovative care model for rural patients undergoing outpatient breast surgery.
机构信息
From the Department of Surgery, Saint John Regional Hospital, Horizon Health Network, Saint John, N.B. (Chiu); the Office of Research Services, Horizon Health Network, Saint John, N.B. (Fowler, Bridges, Hanson, McLaughlin, Gulliver); the Maritime SPOR SUPPORT Unit, Saint John, N.B. (Fowler, Bridges, McLaughlin, Gulliver); the Breast Health Program, St. Joseph's Hospital, Horizon Health Network, Saint John, N.B. (King); the Breast Health Clinic, The Moncton Hospital, Horizon Health Network (Street, Tait); patient partner (Irving), Oak Bay, N.B.; patient partner (McLean), Miramichi, N.B
From the Department of Surgery, Saint John Regional Hospital, Horizon Health Network, Saint John, N.B. (Chiu); the Office of Research Services, Horizon Health Network, Saint John, N.B. (Fowler, Bridges, Hanson, McLaughlin, Gulliver); the Maritime SPOR SUPPORT Unit, Saint John, N.B. (Fowler, Bridges, McLaughlin, Gulliver); the Breast Health Program, St. Joseph's Hospital, Horizon Health Network, Saint John, N.B. (King); the Breast Health Clinic, The Moncton Hospital, Horizon Health Network (Street, Tait); patient partner (Irving), Oak Bay, N.B.; patient partner (McLean), Miramichi, N.B.
出版信息
Can J Surg. 2024 Mar 7;67(2):E77-E84. doi: 10.1503/cjs.004923. Print 2024 Jan-Feb.
BACKGROUND
The Delta Oasis program was launched in New Brunswick in 2006 to offer patients from rural areas who were undergoing breast cancer surgery and their families 1 night of free accommodations and a postoperative consultation with an extramural nurse. We sought to investigate patient experiences with this program.
METHODS
This mixed-method retrospective study took place from 2020 to 2022 and compared the preoperative anxiety and quality of recovery of program participants and control patients who were discharged home over 100 km from hospital. We conducted 2 × 2 analysis of variance to evaluate the effects of intervention group and surgery type. We conducted semistructured interviews with intervention participants, which we then thematically analyzed. Two patient partners were engaged during data synthesis to support the interpretation of results.
RESULTS
We included 34 patients who participated in the program and 18 control patients. No statistically significant differences were found between treatment groups in preoperative anxiety and quality of recovery, regardless of surgery type. Thematic analysis of interviews with 17 intervention participants revealed that they were highly satisfied with the program and that the experience helped reduce stress and discomfort related to their surgery.
INTERPRETATION
The Delta Oasis program is a cost-effective alternative to inpatient care after breast cancer surgery and is highly regarded by rural patients; expansion to other regions with the inclusion of additional low-risk surgeries could help address hospital capacity issues. This study contributes to our understanding of the patient experience with the Delta Oasis program and informs the development of similar programs elsewhere.
背景
2006 年，新不伦瑞克省启动了三角洲绿洲计划，为接受乳腺癌手术的农村地区患者及其家属提供 1 晚的免费住宿和与院外护士的术后咨询。我们旨在调查该计划的患者体验。
方法
这项混合方法的回顾性研究于 2020 年至 2022 年进行，比较了参与该计划的患者和术后出院回家距离医院 100 公里以上的对照组患者的术前焦虑和恢复质量。我们进行了 2×2 方差分析，以评估干预组和手术类型的影响。我们对干预参与者进行了半结构式访谈，然后对其进行主题分析。在数据综合过程中，有 2 名患者伙伴参与，以支持结果的解释。
结果
我们纳入了 34 名参与该计划的患者和 18 名对照组患者。无论手术类型如何，治疗组在术前焦虑和恢复质量方面均无统计学差异。对 17 名干预参与者的访谈进行主题分析表明，他们对该计划非常满意，该体验有助于减轻与手术相关的压力和不适。
结论
三角洲绿洲计划是乳腺癌手术后住院治疗的一种具有成本效益的替代方案，深受农村患者的欢迎；将其扩展到其他地区，并纳入其他低风险手术，可以帮助解决医院容量问题。本研究有助于我们了解患者对三角洲绿洲计划的体验，并为其他地方类似计划的制定提供信息。
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