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运用实施科学识别初级保健提供者使用生存护理计划的促进因素和障碍。

Applying Implementation Science to Identify Primary Care Providers' Enablers and Barriers to Using Survivorship Care Plans.

机构信息

School of Psychology, University of Ottawa, Ottawa, ON K1N 6N5, Canada.

The Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada.

出版信息

Curr Oncol. 2024 Jun 5;31(6):3278-3290. doi: 10.3390/curroncol31060249.

Abstract

Primary care providers (PCPs) have been given the responsibility of managing the follow-up care of low-risk cancer survivors after they are discharged from the oncology center. Survivorship Care Plans (SCPs) were developed to facilitate this transition, but research indicates inconsistencies in how they are implemented. A detailed examination of enablers and barriers that influence their use by PCPs is needed to understand how to improve SCPs and ultimately facilitate cancer survivors' transition to primary care. An interview guide was developed based on the second version of the Theoretical Domains Framework (TDF-2). PCPs participated in semi-structured interviews. Qualitative content analysis was used to develop a codebook to code text into each of the 14 TDF-2 domains. Thematic analysis was also used to generate themes and subthemes. Thirteen PCPs completed the interview and identified the following barriers to SCP use: unfamiliarity with the side effects of cancer treatment (Knowledge), lack of clarity on the roles of different healthcare professionals (Social Professional Role and Identity), follow-up tasks being outside of scope of practice (Social Professional Role and Identity), increased workload, lack of options for psychosocial support for survivors, managing different electronic medical records systems, logistical issues with liaising with oncology (Environmental Context and Resources), and patient factors (Social Influences). PCPs value the information provided in SCPs and found the follow-up guidance provided to be most helpful. However, SCP use could be improved through streamlining methods of communication and collaboration between oncology centres and community-based primary care settings.

摘要

初级保健提供者(PCP)被赋予了管理低危癌症幸存者从肿瘤中心出院后的随访护理的责任。生存护理计划(SCP)是为了促进这种转变而制定的,但研究表明,它们的实施方式存在不一致。需要详细研究影响 PCP 使用 SCP 的促进因素和障碍,以了解如何改进 SCP,并最终促进癌症幸存者向初级保健的过渡。根据理论领域框架(TDF-2)的第二版,制定了采访指南。PCP 参加了半结构化访谈。使用定性内容分析来开发一个代码本,将文本编码到 14 个 TDF-2 领域中的每一个。还使用主题分析生成主题和子主题。13 名 PCP 完成了采访,并确定了使用 SCP 的以下障碍:不熟悉癌症治疗的副作用(知识)、不同医疗保健专业人员角色的不明确(社会专业角色和身份)、随访任务超出实践范围(社会专业角色和身份)、工作量增加、幸存者缺乏心理社会支持的选择、管理不同的电子病历系统、与肿瘤学联系的后勤问题(环境背景和资源)以及患者因素(社会影响)。PCP 重视 SCP 中提供的信息,并发现提供的随访指导最有帮助。然而,通过简化肿瘤中心和社区初级保健机构之间的沟通和协作方法,可以改进 SCP 的使用。

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