与实施社会风险因素查和转诊相关的上下文因素在癌症幸存者中:一种定性研究
Joseph A Astorino1, Mandi L Pratt-Chapman1, Laura Schubel2
1The George Washington Cancer Center, The George Washington School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia.
Preventing chronic disease
|April 4, 2024
概括
瘤团队认识到社会风险对癌症幸存者有影响,但缺乏系统的查和转诊过程. 改善电子健康记录和社区伙伴关系是有效支持的关键.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 健康的社会决定因素
背景情况:
- 诸如粮食不安全和交通障碍等社会风险因素对患者的健康结果产生重大影响.
- 在临床环境中,对社会风险因素的查和转诊的实施仍然有限,特别是在癌症幸存者护理中.
研究的目的:
- 在瘤学环境中探索查和转诊癌症患者的现有实践和挑战,以了解癌症的社会风险因素.
- 确定在癌症生存中实施系统的社会风险因素干预措施的障碍和促进因素.
主要方法:
- 在3个卫生系统中与瘤学团队进行了18次定性,半结构化的采访.
- 利用探索,准备,实施,维持 (EPIS) 框架来指导分析.
- 采用面试成绩单上的专题分析来识别关键主题和模式.
主要成果:
- 参与卫生系统缺乏标准化的癌症幸存者计划和基于电子健康记录 (EHR) 的过程来识别幸存者或记录社会风险.
- 瘤团队承认社会风险因素的影响,但没有系统的查或转诊过程.
- 建议包括指定特定的员工角色,加强电子健康记录数据跟踪和改善社区组织资源管理.
结论:
- 复杂的癌症护理工作流程和不充分的补偿阻碍了诊所工作人员解决社会风险因素的能力.
- 灵活,量身定制的临床工作流程和与社区组织的改善沟通对于成功的查和推计划实施至关重要.
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