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胶质母细胞瘤患者的配偶主要照顾者希望医疗服务提供者了解什么?对一个秘密 Facebook 支持小组的主要照顾者所写信件的定性主题反思分析。

What do spouse primary caregivers of patients with glioblastoma want medical providers to know? A qualitative thematic reflexive analysis of letters written by primary caregivers from a secret Facebook support group.

机构信息

Clinical Research, School of Nursing, College of Health and Human Services, University of North Carolina Wilmington, Wilmington, North Carolina, USA.

Glioblastoma Support Network, Las Vegas, Nevada, USA.

出版信息

BMJ Open. 2024 Mar 12;14(3):e081783. doi: 10.1136/bmjopen-2023-081783.

Abstract

OBJECTIVES

To analyse the content of letters written by female spouse primary caregivers of patients with glioblastoma multiforme (GBM), a devastating and terminal primary brain cancer, and give voice to their experiences for medical providers of patients with GBM.

DESIGN

A qualitative study using reflexive thematic analysis of letters written by female spouses/life partners and primary caregivers of patients with GBM.

PARTICIPANTS

101 current or former female spouse primary caregivers of patients with GBM wrote letters to share with the medical community between July 2019 and August 2019.

INCLUSION CRITERIA

(1) the primary caregiver who is a spouse of a patient with glioblastoma, (2) be a member of the secret Facebook group, 'We are the wives of GBM and this is our story', and (3) completed informed consent for the contents of their letter to be included for primary and secondary data analysis. Participants who wrote letters but did not complete the informed consent were excluded from the study.

RESULTS

Themes from the letters included the patient experiences: (1) medical details of the disease trajectory, (2) interactions of the patient/caregiver dyads with healthcare and (3) the changing patient condition over time. Themes focused on the caregiver experiences: (1) caregiver challenges, (2) caregiver responses and (3) caregiver coping strategies, and description of tangible needs that would help other caregivers in the future. Caregiver needs were highest during the living with disease progression phase. Caregivers wanted more education and to be valued as members of the care team.

CONCLUSION

Shared decision-making through family-centred care would be beneficial for primary caregivers of patients with GBM. These findings provide opportunities to guide more timely and tailored interventions to provide support and improve care for patient/caregiver dyads to help mitigate the burden of this progressive disease and improve quality of life for caregivers.

摘要

目的

分析女性配偶主要照顾者为胶质母细胞瘤(GBM)患者书写的信件内容,胶质母细胞瘤是一种破坏性和终末期原发性脑癌,并为 GBM 患者的医疗服务提供者提供他们的经验。

设计

使用对女性配偶/生活伴侣和 GBM 患者主要照顾者书写的信件进行反思性主题分析的定性研究。

参与者

2019 年 7 月至 2019 年 8 月期间,101 名现任或前任 GBM 患者的女性配偶/主要照顾者为与医疗界分享而写信。

纳入标准

(1)是胶质母细胞瘤患者的主要照顾者,(2)是“我们是 GBM 的妻子,这就是我们的故事”秘密 Facebook 小组的成员,以及(3)完成了对其信件内容的知情同意,以便进行主要和次要数据分析。未完成知情同意而写信的参与者被排除在研究之外。

结果

信件中的主题包括患者的经历:(1)疾病轨迹的医疗细节,(2)患者/照顾者对医疗保健的相互作用,以及(3)患者随时间的变化状况。主题侧重于照顾者的经历:(1)照顾者的挑战,(2)照顾者的反应,以及(3)照顾者的应对策略,以及描述未来对其他照顾者有帮助的有形需求。在疾病进展阶段,照顾者的需求最高。照顾者希望获得更多的教育,并被视为护理团队的一员。

结论

通过以家庭为中心的护理进行共同决策将对 GBM 患者的主要照顾者有益。这些发现为指导更及时和量身定制的干预措施提供了机会,为患者/照顾者提供支持,并改善护理,以帮助减轻这种进行性疾病的负担,提高照顾者的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/184b/10936493/6102dc900506/bmjopen-2023-081783f01.jpg

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