影响中医在癌症治疗中应用的因素：基于患者和医护人员观点的定性元分析
Factors influencing the utilization of Traditional Chinese Medicine in cancer treatment: a qualitative meta-synthesis of patient and healthcare professional perspectives.
作者信息
Xu Runbing, Sun Yanan, Liu Yifei, Pan Jiajun, Han Yingying, Zhang Xinyu, Zhao Hequn, Li Mengfei, Wu Yu, Yu Changhe, Jiang Miao
机构信息
Department of Hematology and Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Xuanwu Hospital, Capital Medical University, Beijing, China.
出版信息
Front Med (Lausanne). 2025 Mar 5;12:1501918. doi: 10.3389/fmed.2025.1501918. eCollection 2025.
BACKGROUND
The complementary role of Traditional Chinese Medicine (TCM) in cancer management has been widely acknowledged. However, its implementation continues to face numerous challenges. Identifying and elucidating the factors that influence the integration of TCM into cancer therapy is essential. Developing effective implementation strategies is crucial to transitioning from theoretical evidence to practical application.
METHODS
A total of nine databases were systematically searched from their inception until 1 October 2023. The review includes qualitative and mixed-method studies examining the attitudes and perceptions of patients and healthcare providers toward the use of TCM in cancer treatment. The studies included were evaluated using a quality assessment tool. An appropriate model or framework was to identify potential facilitators and impediments affecting TCM implementation. Based on the identified barriers, potential behavior change interventions were subsequently developed.
RESULTS
A total of 39 studies are included in the review, comprising 31 qualitative and eight mixed-methods studies. The quality of these studies is acceptable. Key barriers to the implementation of TCM were identified as follows: insufficient knowledge and experience in TCM, neglect of details in doctor-patient communication, limited number of specialists, lack of funding, and absence of a multidisciplinary collaborative atmosphere. In response to these barriers, we recommend improving structured referral pathways, developing a structured communication manual, and other targeted interventions to enhance the integration of TCM in cancer care.
CONCLUSION
This study identifies 48 factors that influence the implementation of TCM and tentatively proposes a series of intervention strategies. Future research should focus on localized empirical studies of factors and strategies in different healthcare settings.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=421822, identifier CRD42023421822.
背景
中医药在癌症管理中的辅助作用已得到广泛认可。然而，其实施仍面临诸多挑战。识别并阐明影响中医药融入癌症治疗的因素至关重要。制定有效的实施策略对于从理论证据向实际应用的转变至关重要。
方法
从各数据库建库至2023年10月1日，系统检索了总共九个数据库。该综述包括定性和混合方法研究，考察患者和医疗服务提供者对中医药用于癌症治疗的态度和看法。纳入的研究使用质量评估工具进行评价。采用适当的模型或框架来识别影响中医药实施的潜在促进因素和阻碍因素。基于所确定的障碍，随后制定了潜在的行为改变干预措施。
结果
该综述共纳入39项研究，包括31项定性研究和8项混合方法研究。这些研究的质量是可以接受的。确定的中医药实施的主要障碍如下：中医药知识和经验不足、医患沟通忽视细节、专科医生数量有限、资金缺乏以及缺乏多学科协作氛围。针对这些障碍，我们建议改善结构化转诊途径、制定结构化沟通手册以及其他有针对性的干预措施，以加强中医药在癌症护理中的整合。
结论
本研究识别了48个影响中医药实施的因素，并初步提出了一系列干预策略。未来的研究应聚焦于不同医疗环境下因素和策略的本地化实证研究。
系统评价注册
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=421822，标识符CRD42023421822 。
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