McErlean Gemma, Ashley Christine, Pradhan Anisha, Yenson Vanessa, Paterson Alana, Farnham Gai, Owen Fran, Watson Anne-Marie, Presgrave Peter, Kerridge Ian, Halcomb Elizabeth
School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Northfields Ave, Wollongong, NSW, Australia.
St George Hospital, Kogarah, NSW, Australia.
J Cancer Surviv. 2024 Aug 17. doi: 10.1007/s11764-024-01658-4.
Survivors of blood and marrow transplantation (BMT) require life-long follow-up involving both tertiary transplant and primary care services. This paper explores the attitudes and preferences of BMT survivors and their carers regarding the transition from BMT centre care to primary care.
This qualitative study involved semi-structured interviews with BMT survivors and carers from New South Wales, Australia. Interviews were audio-recorded, transcribed verbatim and thematically analysed.
Twenty-two BMT survivors and six carers were interviewed. Two themes emerged: (1) 'Relationships with health professionals' and (2) 'Challenges of long-term care'. Participants, particularly rural/regional survivors, had diverse views on the availability of community BMT expertise and identified a range of strategies to optimise care for BMT survivors.
These results highlight the importance BMT survivors and carers place on their relationships with, and ongoing access to, specialised BMT teams for long-term care. While some are happy to receive community-based care, concerns exist about the capacity of primary care providers, particularly in rural and regional areas. Improved support, communication and coordination between BMT centres and primary care may help facilitate a person-centred, sustainable shared care model. Provider education, use of telehealth and clear delineation of roles and responsibilities may assist in this transition.
As BMT survivors live longer post-treatment, transitions of care and sustainable long-term care models are needed. A shared care approach, integrating specialised BMT teams and local primary care, may optimise outcomes but requires further development to balance accessibility, preferences, and specialised care needs.
血液和骨髓移植(BMT)幸存者需要终身随访,涉及三级移植和初级保健服务。本文探讨了BMT幸存者及其护理人员对从BMT中心护理过渡到初级保健的态度和偏好。
这项定性研究包括对澳大利亚新南威尔士州的BMT幸存者和护理人员进行半结构化访谈。访谈进行了录音,逐字转录并进行了主题分析。
对22名BMT幸存者和6名护理人员进行了访谈。出现了两个主题:(1)“与医疗专业人员的关系”和(2)“长期护理的挑战”。参与者,特别是农村/地区的幸存者,对社区BMT专业知识的可用性有不同看法,并确定了一系列优化BMT幸存者护理的策略。
这些结果凸显了BMT幸存者和护理人员对他们与专门的BMT团队的关系以及长期护理中持续获得该团队服务的重视。虽然一些人乐于接受基于社区的护理,但对初级保健提供者的能力存在担忧,特别是在农村和地区。改善BMT中心与初级保健之间的支持、沟通和协调,可能有助于促进以患者为中心的、可持续的共享护理模式。提供者教育、远程医疗的使用以及明确角色和责任的划分可能有助于这一过渡。
随着BMT幸存者治疗后寿命延长,需要护理过渡和可持续的长期护理模式。一种整合专门的BMT团队和当地初级保健的共享护理方法,可能会优化结果,但需要进一步发展以平衡可及性、偏好和专门护理需求。