McLouth Laurie E, Sterba Katherine R, Snavely Anna C, Weaver Kathryn E, Dressler Emily V, Kent Erin E, Adonizio Christian S, Danhauer Suzanne C, Kuzma Charles, Moore Timothy, Nightingale Chandylen L
Department of Behavioral Science, University of Kentucky College of Medicine, Lexington, Kentucky, USA.
Department of Public Health Sciences, Medical University of South Carolina College of Medicine, Charleston, South Carolina, USA.
Psychooncology. 2024 Dec;33(12):e70034. doi: 10.1002/pon.70034.
Providing supportive services to patients and their caregivers is essential to quality cancer care, yet the depth, availability, and infrastructure underlying these services remains unknown in community practice. We assessed these factors among practices within the National Cancer Institute Community Oncology Research Program (NCORP) to guide priorities for comprehensive supportive service(s) development and inform implementation of evidence-based interventions in clinical practice.
Supportive care leaders at NCORP practices completed online surveys regarding availability of services to patients and caregivers within seven domains, service infrastructure (e.g., staffing, technology), and implementation recommendations for caregiver-specific services. Primary outcomes were the proportion of practices offering at least one service in each domain to both populations and the proportion offering caregiver training/education.
Of the 103 participating practice groups, only 15.5% offered at least one service in each domain to both populations; 21.4% offered caregiver training/education. Psychological (83.5%) and spiritual/religious (75.7%) services were most widely available to both; health promotion (28.2%) services were least available to both. Services offered were largely available on-site with dedicated staff; caregiver-specific services were nearly always off-site and typically self-pay. Practices most often used the patient health portal to communicate with patients and caregivers (54.4%). Only 28.9% provided bilingual staff for services. Social workers (35.7%) and navigators (34.7%) were recommended to support caregiver services.
To meet national recommendations for supportive service provision, practices should invest in caregiver education/training programs, expand health promotion programs, and increase interpretation services. Future interventions should leverage existing resources (e.g., recommended staff, patient portal).
为患者及其护理人员提供支持性服务对于高质量癌症护理至关重要，但在社区实践中，这些服务的深度、可及性和基础设施仍然未知。我们评估了美国国立癌症研究所社区肿瘤学研究项目（NCORP）内各医疗机构的这些因素，以指导全面支持性服务发展的优先事项，并为临床实践中循证干预措施的实施提供信息。
NCORP各医疗机构的支持性护理负责人完成了在线调查，内容涉及七个领域内向患者和护理人员提供服务的可及性、服务基础设施（如人员配备、技术）以及针对护理人员特定服务的实施建议。主要结果是在每个领域向这两类人群都提供至少一项服务的医疗机构比例以及提供护理人员培训/教育的医疗机构比例。
在103个参与的医疗机构组中，只有15.5%在每个领域向这两类人群都提供至少一项服务；21.4%提供护理人员培训/教育。心理（83.5%）和精神/宗教（75.7%）服务对这两类人群的可及性最广泛；健康促进（28.2%）服务对这两类人群的可及性最低。所提供的服务大多在现场由专门工作人员提供；针对护理人员的特定服务几乎总是在非现场且通常需自费。医疗机构最常使用患者健康门户网站与患者和护理人员沟通（54.4%）。只有28.9%的机构为服务配备了双语工作人员。建议由社会工作者（35.7%）和导航员（34.7%）来支持护理人员服务。
为满足国家关于提供支持性服务 的建议，医疗机构应投资开展护理人员教育/培训项目，扩大健康促进项目，并增加口译服务。未来的干预措施应利用现有资源（如推荐的工作人员、患者门户网站）。
