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成人癌症患者照顾者与医疗保健专业人员之间的沟通:沟通体验、相关因素、结果和干预措施的综述。

Communication between Caregivers of Adults with Cancer and Healthcare Professionals: a Review of Communication Experiences, Associated Factors, Outcomes, and Interventions.

机构信息

Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA.

School of Nursing, University of Rochester Medical Center, Rochester, NY, USA.

出版信息

Curr Oncol Rep. 2024 Jul;26(7):773-783. doi: 10.1007/s11912-024-01550-5. Epub 2024 May 23.

Abstract

PURPOSE OF REVIEW

Family/unpaid caregivers play an important role in cancer care. This review aims to summarize caregiver communication experiences with healthcare professionals (HCPs).

RECENT FINDINGS

The Caregiver-Centered Communication model defines five core functions that HCPs should achieve when interacting with caregivers, including fostering relationships, exchanging information, recognizing and responding to caregiver emotions, aiding in decision making, and assisting in patient care management. The literature shows that caregivers have both positive and negative communication experiences with HCPs with respect to these five core functions. Factors at the caregiver (e.g., demographic characteristics, information sources, caregiving duration, health status), patient (e.g., demographic and clinical characteristics), and HCP levels (e.g., time constraints in clinical settings, communication skills) are associated with caregiver-HCP communication quality. Studies further show that these communication experiences may affect caregiver outcomes, including quality of life, mental health, resilience, and satisfaction with cancer care. Moreover, poor quality caregiver-HCP communication is associated with patient readmission to the hospital and unmet care needs. Interventions for caregivers or patient-caregiver dyads have been shown to enhance caregiver confidence and increase their engagement in communication with HCPs. Interventions for HCPs have shown efficacy in improving their communication skills, particularly in involving caregivers in decision-making discussions. Given time constraints during medical visits, we suggest conducting a caregiver assessment by navigators prior to visits to understand their communication needs. Additionally, reimbursing HCPs for time spent communicating with caregivers during visits could be beneficial. More research is needed to better understand how to enhance caregiver-HCP communication quality.

摘要

目的综述

家庭/非付费照护者在癌症照护中发挥着重要作用。本综述旨在总结照护者与医疗保健专业人员(HCP)沟通的经验。

最新发现

照护者为中心的沟通模式定义了 HCP 与照护者互动时应实现的五个核心功能,包括建立关系、交流信息、识别和回应照护者的情绪、协助决策和协助患者护理管理。文献表明,照护者与 HCP 就这五个核心功能的沟通体验既有积极的,也有消极的。照护者(如人口统计学特征、信息来源、照护时间、健康状况)、患者(如人口统计学和临床特征)和 HCP 水平(如临床环境中的时间限制、沟通技巧)等因素与照护者-HCP 沟通质量相关。研究进一步表明,这些沟通体验可能会影响照护者的结局,包括生活质量、心理健康、适应力和对癌症照护的满意度。此外,较差的照护者-HCP 沟通与患者再次住院和未满足的护理需求有关。针对照护者或患者-照护者二人组的干预措施已被证明可以增强照护者的信心,并增加他们与 HCP 沟通的积极性。针对 HCP 的干预措施已显示出改善其沟通技巧的功效,特别是在让照护者参与决策讨论方面。鉴于就诊期间时间限制,我们建议在就诊前由导航员对照护者进行评估,以了解他们的沟通需求。此外,为 HCP 在就诊期间与照护者沟通所花费的时间付费可能是有益的。需要进一步研究以更好地了解如何提高照护者-HCP 沟通质量。

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