新冠疫情后针对老年转移性癌症患者的居家护理中的远程姑息治疗：一项民族科学研究
Telepalliative Care in Home-Based Nursing Care for Older Adults With Metastatic Cancer Post COVID-19: An Ethnoscientific Study.
作者信息
Sathiyamas Jinpitcha, Mingmalairak Chatchai, Rungroungdouyboon Bunyong, Sri-Ngernyuang Chawakorn
机构信息
Department of Adult Nursing and the Aged, Faculty of Nursing, Thammasat University, Pathum Thani, Thailand.
Center of Excellence in Creative Engineering Design and Development, Faculty of Engineering, Thammasat University, Pathum Thani, Thailand.
出版信息
SAGE Open Nurs. 2024 Sep 17;10:23779608241279908. doi: 10.1177/23779608241279908. eCollection 2024 Jan-Dec.
INTRODUCTION
The post-COVID-19 pandemic caused the whole world to make several changes to the nursing healthcare system. This sudden shift raised questions about telepalliative care in home-based nursing care in the context of healthcare utilization, including meeting the needs of older adults with metastatic cancer. The evidence suggests that telepalliative care in home-based nursing care is acceptable to most advanced practice nurses, but the extent of their use for metastatic cancer patients has not been defined.
OBJECTIVES
To explore the use of telepalliative care in home-based nursing care for older adults with metastatic cancer in central Thailand following the post-COVID-19 pandemic.
METHODS
A qualitative approach with an ethnoscientific design was used to collect data from a purposive sample of 15 advanced practice nurses from May to September 2023. The interview transcripts were analyzed using componential analysis (core coding, categorizing, theme, and emerging theory).
RESULTS
The componential analysis revealed two themes of telepalliative care in home-based nursing care for older adults with metastatic cancer in the post COVID-19 pandemic. The first theme is telepalliative care delivery, with subthemes of delivering practice, nurse-mediated feedback and supportive care, remote monitoring of real-time emergencies, and transferring medical data. The second theme is advanced practice nurses' (APN) role in telepalliative nursing care, including the subthemes of virtual monitoring, life-threatening cancer, side effects, caregiving capacity, continuity of care, and long-term care services. The study found that caregiving capacity, continuity of care, and long-term care services were formed of telepalliative care in home-based nursing care for cancer patients following the COVID-19 pandemic.
CONCLUSION
Telepalliative care in home-based nursing care is effective in delivering services to older adults with metastatic cancer during the post-COVID-19 pandemic. The findings suggested that remote monitoring of real-time emergencies, life-threatening cancer, and long-term care services are part of telepalliative care in home-based nursing care. Adapting the telepalliative competency standards of advanced practice nurses is needed to ensure high-quality healthcare access for older adults with metastatic cancer during the post-COVID-19 pandemic.
引言
新冠疫情后，全球对护理医疗体系做出了多项变革。这一突然转变引发了关于居家护理中远程姑息治疗在医疗利用背景下的问题，包括满足转移性癌症老年患者的需求。有证据表明，居家护理中的远程姑息治疗为大多数高级实践护士所接受，但他们对转移性癌症患者的使用程度尚未明确。
目的
探讨新冠疫情后泰国中部居家护理中远程姑息治疗在转移性癌症老年患者中的应用。
方法
采用民族科学设计的定性方法，于2023年5月至9月从15名高级实践护士的目的样本中收集数据。使用成分分析法（核心编码、分类、主题和新兴理论）对访谈记录进行分析。
结果
成分分析揭示了新冠疫情后居家护理中针对转移性癌症老年患者的远程姑息治疗的两个主题。第一个主题是远程姑息治疗的提供，包括实践提供、护士介导的反馈和支持性护理、实时紧急情况的远程监测以及医疗数据的传输等子主题。第二个主题是高级实践护士在远程姑息护理中的角色，包括虚拟监测、危及生命的癌症、副作用、护理能力、护理连续性和长期护理服务等子主题。研究发现，护理能力、护理连续性和长期护理服务是新冠疫情后居家护理中针对癌症患者的远程姑息治疗所形成的。
结论
居家护理中的远程姑息治疗在新冠疫情后为转移性癌症老年患者提供服务方面是有效的。研究结果表明，实时紧急情况的远程监测、危及生命的癌症和长期护理服务是居家护理中远程姑息治疗的一部分。需要调整高级实践护士的远程姑息治疗能力标准，以确保新冠疫情后转移性癌症老年患者能够获得高质量的医疗服务。
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