Tremblay Dominique, Russo Chiara, Terret Catherine, Prady Catherine, Joannette Sonia, Lessard Sylvie, Usher Susan, Pretet-Flamand Émilie, Galvez Christelle, Gélinas-Phaneuf Élisa, Terrier Julien, Moreau Nathalie
Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC J4K 0A8, Canada.
Centre de Recherche Charles-Le Moyne, Longueuil, QC J4K 0A8, Canada.
Curr Oncol. 2025 Aug 16;32(8):465. doi: 10.3390/curroncol32080465.
The growing number of older adults with cancer confront practical and organizational limitations that hinder their ability to obtain care that is adapted to their health status, needs, expectations, and life choices. The integration into practice of evidence-based and institutional recommendations for a geriatric approach and person-centered high-quality care remains incomplete. This study uses an action research design to explore stakeholders' perspectives of the challenges involved in translating the established care priorities into a compassionate geriatric approach in oncology and identify promising pathways to improvement. Fifty-three stakeholders participated in focus groups to create cognitive maps representing perceived relationships between concepts related to compassionate care of older adults with cancer. Combining maps results in a single model constructed in Mental Modeler software to weigh relationships and calculate concept centrality (importance in the model). The model represents stakeholders' collective perspective of the determinants of compassionate care that need to be addressed at different decision-making levels. The results reveal pathways to improvement at systemic, organizational, practice, and societal levels. These include connecting policies on ageing and national cancer programs, addressing fragmented care through interdisciplinary teamwork, promoting person-centered care, cultivating relational proximity, and combatting ageism. Translating evidence-based practices and priority orientations into compassionate care rests on collective capacities across multiple providers to address the whole person and their unique trajectory.
患癌老年人数量不断增加，他们面临着实际和组织方面的限制，这阻碍了他们获得适合其健康状况、需求、期望和生活选择的护理。将基于证据的机构性建议融入老年医学方法和以患者为中心的高质量护理实践中，这一工作仍未完成。本研究采用行动研究设计，以探讨利益相关者对在肿瘤学中将既定护理重点转化为富有同情心的老年医学方法所涉及挑战的看法，并确定有前景的改进途径。53名利益相关者参与了焦点小组，以创建认知图，描绘与患癌老年人的同情护理相关概念之间的感知关系。将这些图合并，形成在心智建模软件中构建的单一模型，以权衡关系并计算概念中心性（在模型中的重要性）。该模型代表了利益相关者对在不同决策层面需要解决的同情护理决定因素的集体观点。结果揭示了在系统、组织、实践和社会层面的改进途径。这些途径包括将老龄化政策与国家癌症项目联系起来，通过跨学科团队合作解决护理碎片化问题，促进以患者为中心的护理，培养关系亲近感，以及消除年龄歧视。将基于证据的实践和优先方向转化为同情护理，依赖于多个提供者的集体能力，以关注患者的整体及其独特轨迹。
