Academic Nursing Unit, Peter MacCallum Cancer Centre, Parkville, Victoria, Australia.
Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Health Expect. 2024 Jun;27(3):e14089. doi: 10.1111/hex.14089.
Despite significant advances in the management of lung cancer, patients continue to experience a high burden of unmet need impacting quality of life and outcomes of care. Achieving value-based health care, where investment is targeted to services that deliver optimal experience and outcomes of care relative to the cost of delivering that care, requires attention to what people value most in meeting their needs. To date there has been little attention to what matters most to patients with lung cancer (i.e., what they value) as a component of achieving value-based cancer care. This qualitative study was undertaken to investigate components of care valued by people with lung cancer in Australia.
This qualitative study used semistructured interviews with 23 people with lung cancer. Participants were recruited using a purposive sampling strategy from two metropolitan tertiary public health services. Data collected included demographic characteristics and patient perspectives regarding their priority concerns and components of care identified as most valuable in meeting their needs. Demographic characteristics of participants were analysed descriptively, and qualitative data were analysed thematically using Interpretive Description.
Data analysis generated three key themes: valued components of care; benefits of receiving valued care components and consequences of missed opportunities for care. The components of care valued by patients reflect the core dimensions of cancer supportive care, with particular emphasis on ongoing opportunities for consultation (screening for unmet needs) and provision of person-centred information. The facilitation of trust between patients and their treating team, as a consequence of having these valued components evident in their care, was identified as a key characteristic of value-based care.
This study has identified valued components of care described by people with lung cancer. Importantly, the care components identified have been proven to improve access to and coordination of care, and demonstrate the importance of integrating supportive care into care provision to achieve value-based cancer care.
This study was informed by perspectives of lung cancer patients who participated in semistructured interviews. We acknowledge that this contribution does not meet the criteria for patient and public involvement in research as defined by Health Expectations, but this study forms part of a larger program of cancer supportive care work being undertaken by this team, where comprehensive consumer engagement and co-design approaches are embedded in our work.
尽管在肺癌治疗方面取得了重大进展，但患者仍面临着大量未满足的需求，这影响了他们的生活质量和治疗效果。实现基于价值的医疗保健，即针对提供最佳治疗体验和效果的服务进行投资，同时考虑到提供这些服务的成本，这需要关注人们在满足需求方面最看重的是什么。迄今为止，对于肺癌患者（即他们重视的内容）在实现基于价值的癌症护理方面的重要性，关注甚少。本定性研究旨在调查澳大利亚肺癌患者所看重的护理内容。
本定性研究采用半结构式访谈，对 23 名肺癌患者进行了访谈。参与者是通过两家大都市三级公立卫生服务机构的目的抽样策略招募的。收集的数据包括人口统计学特征以及患者对其优先关注事项和被认为最能满足其需求的护理内容的看法。参与者的人口统计学特征进行了描述性分析，使用解释性描述对定性数据进行了主题分析。
数据分析生成了三个主要主题：有价值的护理内容；接受有价值的护理内容的好处；以及错失护理机会的后果。患者看重的护理内容反映了癌症支持性护理的核心维度，特别强调持续提供咨询机会（未满足需求的筛查）和提供以患者为中心的信息。患者与治疗团队之间信任的建立，是由于这些有价值的护理内容在治疗中得到体现，这被认为是基于价值的护理的一个关键特征。
本研究确定了肺癌患者所描述的有价值的护理内容。重要的是，已证实这些确定的护理内容可改善对护理的获取和协调，并证明将支持性护理纳入护理提供中对于实现基于价值的癌症护理非常重要。
本研究是基于参与半结构式访谈的肺癌患者的观点得出的。我们承认，这一贡献不符合《健康期望》定义的患者和公众参与研究的标准，但本研究是该团队正在进行的癌症支持性护理工作的更大计划的一部分，其中综合的消费者参与和共同设计方法被嵌入我们的工作中。
