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通过评估工作系统因素对以患者为中心的护理及护理质量的影响来验证以患者为中心的癌症护理框架的有效性:对新诊断癌症患者的访谈研究

Validating the Effectiveness of the Patient-Centered Cancer Care Framework by Assessing the Impact of Work System Factors on Patient-Centered Care and Quality of Care: Interview Study With Newly Diagnosed Cancer Patients.

作者信息

Elkefi Safa, Asan Onur

机构信息

School of Nursing, Columbia University, New York, NY, United States.

School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, United States.

出版信息

JMIR Hum Factors. 2024 Apr 24;11:e53053. doi: 10.2196/53053.

Abstract

BACKGROUND

Patients with cancer who have recently been diagnosed have distinct requirements compared to cancer survivors. It is crucial to take into account their unique needs to ensure that they make informed decisions and are receptive to the care provided.

OBJECTIVE

This study suggested a framework titled Effectiveness of Patient-Centered Cancer Care that considers the needs of newly diagnosed patients with cancer and related work system factors. This study investigated how work system factors influence the perceptions of patient-centered care, quality of care, and associated outcomes among newly diagnosed patients with cancer. Patient-centered care is defined in terms of workload and communication considerations, whereas the quality of care is assessed through indicators such as trust in physicians, satisfaction with care, and perceptions of technology.

METHODS

This study used qualitative data collected through interviews with newly diagnosed patients with cancer (N=20) right after their first visits with their physicians. Thematic analysis was conducted to validate the 5 hypotheses of the framework, mapping the interactions among quality of care, patient-centered care, and work system factors.

RESULTS

We found that workload and patient-centered communication impact the quality of care and that the work system elements impact the patient-centeredness (workload and communication) and the quality of care (trust in physicians, satisfaction with care, and perception of technology use).

CONCLUSIONS

Qualitatively validating the proposed Effectiveness of Patient-Centered Cancer Care framework, this study demonstrated its efficacy in elucidating the interplay of various factors. The framework holds promise for informing interventions geared toward enhancing patients' experiences during their initial visits after diagnosis. There is a pressing need for heightened attention to the organizational design, patient processes, and collaborative efforts among diverse stakeholders and providers to optimize the overall patient experience.

摘要

背景

与癌症幸存者相比,近期被诊断出患有癌症的患者有不同的需求。考虑到他们的独特需求对于确保他们做出明智的决定并接受所提供的护理至关重要。

目的

本研究提出了一个名为“以患者为中心的癌症护理有效性”的框架,该框架考虑了新诊断的癌症患者的需求以及相关的工作系统因素。本研究调查了工作系统因素如何影响新诊断的癌症患者对以患者为中心的护理、护理质量及相关结果的认知。以患者为中心的护理是根据工作量和沟通考量来定义的,而护理质量则通过对医生的信任、对护理的满意度以及对技术的认知等指标来评估。

方法

本研究使用了通过对首次就诊后新诊断的癌症患者(N = 20)进行访谈收集的定性数据。进行了主题分析以验证该框架的5个假设,描绘护理质量、以患者为中心的护理和工作系统因素之间的相互作用。

结果

我们发现工作量和以患者为中心的沟通会影响护理质量,并且工作系统要素会影响以患者为中心的程度(工作量和沟通)以及护理质量(对医生的信任、对护理的满意度以及对技术使用的认知)。

结论

本研究通过定性验证所提出的“以患者为中心的癌症护理有效性”框架,证明了其在阐明各种因素相互作用方面的功效。该框架有望为旨在改善患者诊断后首次就诊期间体验的干预措施提供信息。迫切需要更加关注组织设计、患者流程以及不同利益相关者和提供者之间的协作努力,以优化整体患者体验。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d21/11079762/410a9cd93f37/humanfactors_v11i1e53053_fig1.jpg

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