什么时候以及如何与癌症患者讨论息护理和预先护理规划:一项混合方法研究
Fulvio Bergamo Trevizan1, Carlos Eduardo Paiva1, Laura Fiacadori de Almeida1
1GPQual - Research Group on Palliative Care and Quality of Life - Barretos Cancer Hospital, Barretos, São Paulo, Brazil.
Palliative & supportive care
|October 27, 2023
概括
已婚,受过高等教育的乳腺癌患者更容易接受有关息治疗 (PC) 和预先护理计划 (ACP) 的讨论. 早期,开放的沟通是关键,但避免隐信息或侵犯自主权,特别是晚期癌症患者.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 癌症患者支持 癌症患者支持
背景情况:
- 关于息治疗 (PC) 和预先护理计划 (ACP) 的讨论对癌症患者至关重要.
- 确定最有可能参与这些讨论的患者个人资料对于有效的沟通至关重要.
- 了解首选的时间和方法可以改善以患者为中心的护理.
研究的目的:
- 确定最容易接受PC和ACP讨论的患者.
- 确定这些对话的最佳时间和沟通策略.
- 制定一个框架,在不同癌症阶段讨论PC和ACP.
主要方法:
- 一项混合方法研究,涉及18-75岁的女性,被诊断患有乳腺癌.
- 定量阶段:评估社会人口统计学,临床因素,知识,决策和耻辱.
- 定性阶段:探索患者的理解,时间和讨论PC/ACP的方法,通过内容分析进行分析.
主要成果:
- 完成两阶段研究的参与者更有可能结婚,受过高等教育,并拥有更好的PC/ACP知识.
- 拒绝进一步参与的患者通常患有晚期癌症,并正在接受息治疗.
- 定性主题强调了时间,解密,患者赋权,消除误解和开放沟通的重要性.
结论:
- 早期的PC和ACP讨论是有益的,但患者的自主权和知情同意至关重要.
- 已婚和受过高等教育的患者表现出更高的接受度;晚期癌症患者可能会拒绝参与.
- 有效的沟通策略应侧重于揭穿PC的神秘面,赋予患者权力,解决误解,以促进知情决策.
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