在社区瘤实践中使用向癌症治疗的决定因素:使用理论领域框架和Rummler-Brache过程映射的定性研究
Shellie D Ellis1, Joanna Veazey Brooks2, Sarah A Birken3
1University of Kansas School of Medicine, 3901 Rainbow Blvd., Kansas City, KS, 66610, USA. Sellis4@kumc.edu.
Implementation science communications
|June 12, 2023
概括
识别精确癌症药物的障碍至关重要. 基因组测试中的角色调整和针对性治疗的资源可用性是社区瘤学计划的关键决定因素.
科学领域:
- 在瘤学瘤学.
- 基因组学就是基因组学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 精准医学为癌症患者提供了显著的好处,改善了结果和生活质量.
- 然而,在使用向癌症疗法方面存在差异.
- 本研究研究了影响社区瘤学环境中针对性治疗使用的因素.
研究的目的:
- 在社区瘤学计划中全面识别针对性治疗使用的决定因素.
- 了解影响基因组测试订购和向治疗的障碍和促进因素.
主要方法:
- 与24名社区癌症护理提供者的半结构面试.
- 使用Rummler-Brache图表对11个癌症护理团队的流程映射.
- 使用理论领域框架和模板分析进行定性分析,用于编码转录.
主要成果:
- 报告称,对精准医疗药物供应有很高的意愿,但需要大量的知识.
- 确定了基因组测试订单 (角色调整) 和向治疗 (资源,成本抵消) 的独特决定因素.
- 病理学家发起的基因组测试与更高的测试率相关;低体积和农村计划面临交付挑战.
结论:
- 角色重新调整,特别是让病理学家参与基因组测试,可以改善符合条件的患者的识别.
- 资源的可用性和成本抵消对于有针对性的治疗提供至关重要,特别是在较小或农村的项目中.
- 整合行为科学和过程映射有助于识别准确医学实施的上下文适应.
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