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患者、伴侣、基层及医院医护人员对晚期癌症及全身治疗生活状况的看法。

Perspectives of patients, partners, primary and hospital-based health care professionals on living with advanced cancer and systemic treatment.

作者信息

Kolsteren Evie E M, Deuning-Smit Esther, Prins Judith B, van der Graaf Winette T A, Kwakkenbos Linda, Custers José A E

机构信息

Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.

Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.

出版信息

J Cancer Surviv. 2024 Oct 29. doi: 10.1007/s11764-024-01698-w.

Abstract

PURPOSE

An emerging group of patients lives longer with advanced cancer while receiving systemic treatment. This study aimed to investigate psychosocial aspects of living longer with advanced cancer, and experiences with psychosocial care, from the perspectives of patients, partners, and health care professionals (HCPs).

METHODS

From May to December 2020, participants were purposively selected. In-depth, semi-structured interviews were conducted by video or phone call, containing open questions regarding psychosocial aspects and psychosocial care in oncology. The data was analysed following thematic analysis, leading to overarching psychosocial themes and indications for optimal organisation of psycho-oncological care.

RESULTS

Fifteen patients, seven partners and eleven HCPs were interviewed. The main psychosocial aspects were increasing loss in several life domains, complexity of making life choices, ongoing uncertainty, and fluctuating fear and hope. Partners were affected by their loved ones' condition and reported to put themselves second for longer periods of time, while sometimes missing adequate support. HCPs were challenged by addressing the altering psychosocial needs of patients, and tools to identify those in need for psychosocial support are currently lacking.

CONCLUSIONS

Living longer with advanced cancer presents unique challenges for patients and their partners, as well as for HCPs in delivering optimal psychosocial care.

IMPLICATIONS FOR CANCER SURVIVORS

Identifying and addressing patients' psychosocial needs from an early stage on, appointing a central hospital-based contact person, limiting the waiting time between scans and consultations, and addressing the partners' wellbeing are suggestions to organise optimal psychosocial support in advanced cancer.

摘要

目的

有一群新出现的患者在接受全身治疗的同时,带着晚期癌症存活的时间更长。本研究旨在从患者、伴侣和医护人员的角度,调查晚期癌症患者长期存活的心理社会方面,以及心理社会护理的经历。

方法

2020年5月至12月,采用目的抽样法选取参与者。通过视频或电话进行深入的半结构化访谈,包含关于肿瘤学中心理社会方面和心理社会护理的开放性问题。按照主题分析法对数据进行分析,得出总体心理社会主题以及心理肿瘤护理优化组织的指征。

结果

对15名患者、7名伴侣和11名医护人员进行了访谈。主要的心理社会方面包括在多个生活领域中日益增加的丧失感、做出生活选择的复杂性、持续的不确定性以及波动的恐惧和希望。伴侣受到其亲人病情的影响,报告称自己长时间将自己置于次要位置,同时有时缺乏足够的支持。医护人员在应对患者不断变化的心理社会需求方面面临挑战,目前缺乏识别需要心理社会支持的患者的工具。

结论

晚期癌症患者长期存活给患者及其伴侣以及医护人员提供最佳心理社会护理带来了独特的挑战。

对癌症幸存者的启示

从早期就识别并满足患者的心理社会需求、指定一名以医院为中心的联系人、缩短扫描和会诊之间的等待时间以及关注伴侣的福祉,这些都是在晚期癌症中组织最佳心理社会支持的建议。

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