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非洲国家癌症控制计划中的心理社会和姑息治疗:一项定性研究。

Psychosocial and palliative care in African national cancer control plans: A qualitative study.

机构信息

Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada.

Lady Davis Institute for Medical Research, Montreal, Quebec, Canada.

出版信息

Psychooncology. 2024 May;33(5):e6346. doi: 10.1002/pon.6346.

Abstract

OBJECTIVE

Low and middle income countries of Africa account for a disproportionate amount of the global health burden of cancer. Providing patients access to psychosocial oncology and palliative care through policy structures such as the National Cancer Control Plans (NCCP) is essential to improving the care provided to patients and their families. The first phase of this study sought to determine the extent to which palliative care and psychosocial oncology were integrated in NCCPs in African countries.

METHODS

A qualitative thematic analysis of the plans was used using Nvivo, with two-raters coding and continuous team discussions. Data were organized into an infographic map showing the coverage of themes across African countries.

RESULTS

Fifty-eight NCCPs and NCD plans were analyzed in the 54 countries in Africa. The findings illustrate a lack of standardization across countries' NCCPs in addressing psychosocial oncology and palliative care themes. Certain areas presented good coverage across several plans, such as barriers to access, education, awareness, and health behaviors, coordination of care, families, caregivers and community involvement, and palliative care. Other themes presented low coverage, such as doctor-patient communication, mental health, bereavement, psychosocial care, survivorship care, and traditional medicine.

CONCLUSIONS

One may consider further developing NCCP areas as they pertain to psychosocial oncology and palliative care to ensure their proper place on the policy agenda for a healthier Africa.

摘要

目的

非洲的中低收入国家承担了不成比例的全球癌症负担。通过国家癌症控制计划(NCCP)等政策结构为患者提供心理肿瘤学和姑息治疗服务,对于改善为患者及其家属提供的护理至关重要。本研究的第一阶段旨在确定姑息治疗和心理肿瘤学在非洲国家 NCCP 中的整合程度。

方法

使用 Nvivo 对计划进行定性主题分析,两名评分员进行编码,并进行持续的团队讨论。数据组织成一张信息图,显示主题在非洲国家的覆盖范围。

结果

对非洲 54 个国家的 58 个 NCCP 和非传染性疾病计划进行了分析。调查结果表明,各国 NCCP 在解决心理肿瘤学和姑息治疗主题方面缺乏标准化。某些领域在多个计划中得到了很好的覆盖,例如获得服务的障碍、教育、意识和健康行为、护理协调、家庭、照顾者和社区参与以及姑息治疗。其他主题的覆盖范围较低,例如医患沟通、心理健康、丧亲之痛、心理社会关怀、生存者护理和传统医学。

结论

人们可能会考虑进一步制定与心理肿瘤学和姑息治疗相关的 NCCP 领域,以确保它们在非洲更健康的政策议程上占有适当的位置。

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