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澳大利亚泌尿生殖系统癌症护士认为在患者护理、教育和研究方面存在哪些未满足的需求?一项混合方法研究。

What are the perceived unmet needs for patient care, education, and research among genitourinary cancer nurses in Australia? A mixed method study.

作者信息

Paterson Catherine, Anderson Helen, Rosano Michelle, Cowan Donna, Schulz Diana, Santoro Kerry, Forshaw Tina, Hawks Cynthia, Roberts Natasha

机构信息

Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.

Central Adelaide Local Health Network, Adelaide, Australia.

出版信息

Asia Pac J Oncol Nurs. 2024 Jul 25;11(9):100564. doi: 10.1016/j.apjon.2024.100564. eCollection 2024 Sep.

Abstract

OBJECTIVE

Specialist genitourinary (GU) nurses provide care to a broad and diverse group of patients diagnosed with kidney, bladder, prostate, testicular, adrenal, and penile cancer. The purpose of this study was to identify GU cancer nurse perspectives of perceived unmet needs in service provision, specific educational and research priorities.

METHODS

A concurrent mixed methods study design incorporated quantitative and qualitative data collection from the GU Cancer nurses workforce in Australia. Quantitative data collected using an electronic survey instrument and were analysed using descriptive statistics. Qualitative data collected through semi-structured interviews and coded for thematic analysis. Ethical approval was gained.

RESULTS

Fifty responses were received from the electronic survey. 39/50 (78%) were female and 35 (70%) were metropolitan based. The highest domains of perceived unmet needs related to psychological/emotional needs - 17/23 (74%), intimacy needs - 15/23 (65%) and informational needs - 13/23 (57%). The themes from the qualitative interviews identified: (1) Patient needs - lack of tumour specific contact for cancer patients, fragmented delivery of cancer care, perception of better access to supportive care for public patients, lack of access to supportive care screening tools for needs assessment. (2) Educational needs - lack of GU specific cancer educational resources/learning opportunities and barriers to accessing educational opportunities. (3) Research priorities - impact on carers/partners, specific needs of different GU cancers, future focus on genetic testing/counselling, interventions for financial toxicity and development of models of care for geriatric GU patients.

CONCLUSIONS

Specialist GU cancer nurses support a broad group of patients. Given the prominence of addressing unmet cancer care needs among people with GU cancers in this study, cancer nursing as a discipline alongside the multidisciplinary team, requires innovative solutions to overcome fragmented care which is often highly complex, and develop individualised and integrated care across the cancer care continuum. We encourage clinicians, researchers, policy makers, people affected by cancer, and their care networks, to continue to drive innovation by (1) Embedding an integrated approach to cancer nursing, (2) Implementation of shared care, (3) Implementation of patient navigation, (4) Embracing emerging technologies, (5) Future focus on education, and (6) Future focus on nurse-led research.

摘要

目的

专科泌尿生殖科(GU)护士为被诊断患有肾癌、膀胱癌、前列腺癌、睾丸癌、肾上腺癌和阴茎癌的广泛且多样的患者群体提供护理。本研究的目的是确定GU癌症护士对服务提供中未满足需求的看法、具体的教育和研究重点。

方法

一项同期混合方法研究设计纳入了从澳大利亚GU癌症护士群体中收集的定量和定性数据。使用电子调查工具收集定量数据,并使用描述性统计进行分析。通过半结构化访谈收集定性数据,并进行编码以进行主题分析。获得了伦理批准。

结果

电子调查共收到50份回复。50人中39人(78%)为女性,35人(70%)来自大都市地区。未满足需求的最高领域与心理/情感需求相关——23人中17人(74%)、亲密需求——23人中15人(65%)和信息需求——23人中13人(57%)。定性访谈的主题包括:(1)患者需求——癌症患者缺乏特定肿瘤接触、癌症护理提供碎片化、认为公立患者更容易获得支持性护理、缺乏用于需求评估的支持性护理筛查工具。(2)教育需求——缺乏GU特定的癌症教育资源/学习机会以及获得教育机会的障碍。(3)研究重点——对护理人员/伴侣的影响、不同GU癌症的特定需求、未来对基因检测/咨询的关注、针对经济毒性的干预措施以及老年GU患者护理模式的开发。

结论

专科GU癌症护士为广泛的患者群体提供支持。鉴于本研究中解决GU癌症患者未满足的癌症护理需求的突出性,癌症护理作为一门学科,与多学科团队一起,需要创新解决方案来克服通常高度复杂的碎片化护理,并在癌症护理连续过程中开发个性化和综合护理。我们鼓励临床医生、研究人员、政策制定者、受癌症影响的人群及其护理网络,通过以下方式继续推动创新:(1)采用综合的癌症护理方法,(2)实施共享护理,(3)实施患者导航,(4)采用新兴技术,(5)未来关注教育,(6)未来关注护士主导的研究。

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