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为少数民族癌症患者创造更安全的医疗服务:癌症服务人员的经验定性分析。

Creating safer cancer care with ethnic minority patients: A qualitative analysis of the experiences of cancer service staff.

机构信息

Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Macquarie Park, New South Wales, Australia.

School of Nursing and Midwifery, Monash University, Clayton, Victoria, Australia.

出版信息

Health Expect. 2024 Feb;27(1):e13979. doi: 10.1111/hex.13979.

Abstract

INTRODUCTION

Effective consumer engagement practices can enhance patient safety. This is important for consumers from ethnic minority backgrounds who are exposed to increased risk of patient safety events. Using the Systems Engineering Initiative for Patient Safety model, this study explored staff experiences of creating opportunities for engagement with consumers from ethnic minority backgrounds to contribute to their cancer care safety.

METHOD

A qualitative study was conducted using semistructured interviews with cancer service staff from four cancer services across two states in Australia. Purposive sampling was used to recruit healthcare staff from a diverse range of professions. Data were analysed using the Framework Analysis method.

RESULTS

Fifty-four interviews were conducted with healthcare staff. Analysis of the qualitative interview data identified enablers and associated challenges that contributed to creating a shared understanding between consumers and staff of the information, processes, expectations and problems arising in care. Enablers and challenges are reported in relation to four themes: (1) co-creating safety through shared understanding of care processes; (2) tools and technologies support planned communication; (3) organisational policy levers exist but lack implementation in direct care and (4) formal tasks incorporate consumer engagement more readily than informal interactions.

CONCLUSION

The availability of infrastructure and resources to support communication with consumers from ethnic minority backgrounds was limited to specific tasks across the cancer care continuum. Strategies implemented by health services to foster effective communication during formal interactions now require expansion to support and create conditions for effective consumer engagement during informal and everyday care tasks. The use of innovative language support tools and cultural considerations are required at the service and system level to support consumer engagement in all types of care interactions.

PUBLIC AND PATIENT INVOLVEMENT

The study was embedded within a larger project that included a consumer investigator and was guided by a consumer advisory group (CAG). These consumer team members have lived experience of cancer and are from diverse ethnic backgrounds. CAG members provided feedback on the draft interview guide and participant information for this study.

摘要

介绍

有效的消费者参与实践可以提高患者安全。对于来自少数民族背景的消费者来说,这一点尤为重要,因为他们面临着更高的患者安全事件风险。本研究利用患者安全系统工程倡议模型,探讨了工作人员为来自少数民族背景的消费者创造参与机会,以促进其癌症护理安全的经验。

方法

本研究采用定性研究方法,对澳大利亚两个州的四个癌症服务机构的癌症服务工作人员进行了半结构式访谈。采用目的抽样法招募了来自不同专业的医疗保健人员。使用框架分析方法对数据进行分析。

结果

对医疗保健人员进行了 54 次访谈。对定性访谈数据的分析确定了促进消费者和工作人员对护理过程中的信息、流程、期望和问题达成共同理解的促成因素和相关挑战。促成因素和挑战与以下四个主题相关:(1)通过共同理解护理流程来共同创造安全;(2)工具和技术支持计划沟通;(3)组织政策杠杆存在,但在直接护理中缺乏实施;(4)正式任务比非正式互动更能融入消费者参与。

结论

支持与少数民族背景消费者沟通的基础设施和资源仅限于癌症护理连续体中的特定任务。卫生服务部门为促进正式互动期间的有效沟通而实施的策略现在需要扩大,以支持和创造条件,使非正式和日常护理任务中的有效消费者参与成为可能。需要在服务和系统层面使用创新的语言支持工具和文化考虑因素,以支持消费者参与所有类型的护理互动。

公众和患者参与

该研究嵌入在一个更大的项目中,该项目包括一名消费者调查员,并由一个消费者咨询小组(CAG)指导。这些消费者团队成员有癌症的生活经历,并且来自不同的种族背景。CAG 成员对本研究的访谈指南草案和参与者信息提供了反馈。

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