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将家庭照顾者纳入癌症护理:将循证照顾者协议应用于妇科肿瘤学实践

Integrating Family Caregivers Into Cancer Care: Implementation of Evidence-Based Caregiver Protocols Into Gynecologic Oncology Practice.

作者信息

Thomas Teresa Hagan, Campbell Grace, Tan Kelly R, Murray Patty Jo, Loughlin Kimm, Roberge Mary C, Wang Youjia, Lee Young Ji, DiLello Ryan, Donovan Heidi S

机构信息

School of Nursing, University of Pittsburgh, Pittsburgh, PA.

Palliative Research Center (PaRC), University of Pittsburgh, Pittsburgh, PA.

出版信息

JCO Oncol Pract. 2025 Apr;21(4):476-484. doi: 10.1200/OP.24.00383. Epub 2024 Aug 21.

Abstract

PURPOSE

Family caregivers (CGs) of individuals with cancer are increasingly relied upon to provide long-term, sometimes intense care, although their integration into clinical cancer care remains minimal. The Caregiver Advocacy, Research, and Education (CARE) Center is a novel nurse-led academic-clinical partnership to support family CGs of individuals with gynecologic cancer. This study aims to describe the implementation of the Center protocols and report metrics of CG needs and Center support.

MATERIALS AND METHODS

The Center's goals are to identify, assess, and provide tailored support to CGs. Initially, Center protocols included assessment of CGs' self-identified distress (distress thermometer, 0 = no distress to 10 = extreme distress) and needs (yes or no). Tailored support on the basis of CG distress was provided by in-person and remote staff who provided complementary, concurrent support based on CG need: evidence-based self-management guides, self-management support, referral to specialty services. Center documentation was analyzed to describe Center reach and CG distress.

RESULTS

From November 2019 to June 2023, CGs (N = 1,250) were identified through referrals, new patient outreach, and inpatient visits. Seven hundred and six CGs (56.5%) were assessed through a needs-based assessment, and 515 (41.2%) CGs received tailored support. CGs were mostly men (53.0%) and the mean distress was 4.4/10 (standard deviation, 3.1). CG distress was moderately associated with CG needs including maintaining emotional (ρ = 0.40; < .001) and physical (ρ = 0.31; < .001) health and managing patient symptoms (ρ = 0.33; < .001).

CONCLUSION

Center protocols facilitate identification of high-need CGs within a cancer clinic. Future research will longitudinally evaluate the impact of Center protocols on CG and patient outcomes, incorporating updated assessment tools.

摘要

目的

尽管癌症患者的家庭护理人员(CGs)融入临床癌症护理的程度仍然很低,但他们越来越多地被依赖提供长期、有时是高强度的护理。护理人员倡导、研究和教育(CARE)中心是一种新型的由护士主导的学术 - 临床合作关系,旨在支持妇科癌症患者的家庭护理人员。本研究旨在描述该中心方案的实施情况,并报告护理人员需求和中心支持的指标。

材料与方法

该中心的目标是识别、评估并为护理人员提供量身定制的支持。最初,中心方案包括评估护理人员自我认定的痛苦程度(痛苦温度计,0 = 无痛苦至10 = 极度痛苦)和需求(是或否)。根据护理人员的痛苦程度提供的量身定制的支持由现场和远程工作人员提供,他们根据护理人员的需求提供互补、同步的支持:基于证据的自我管理指南、自我管理支持、转介至专科服务。对中心文档进行分析以描述中心的覆盖范围和护理人员的痛苦程度。

结果

从2019年11月到2023年6月,通过转诊、新患者外展和住院患者访视识别出护理人员(N = 1250)。706名护理人员(56.5%)通过基于需求的评估进行了评估,515名(41.2%)护理人员接受了量身定制的支持。护理人员大多为男性(53.0%),平均痛苦程度为4.4/10(标准差,3.1)。护理人员的痛苦程度与护理人员的需求存在中度关联,包括维持情绪(ρ = 0.40;< .001)和身体(ρ = 0.31;< .001)健康以及管理患者症状(ρ = 0.33;< .001)。

结论

中心方案有助于在癌症诊所内识别高需求的护理人员。未来的研究将纵向评估中心方案对护理人员和患者结局的影响,并纳入更新的评估工具。

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