在综合癌症中心的门诊环境中为晚期癌症患者实施决策辅助的可行性:宝贵的经验教训
K Laryionava1, R Boekels1, J Schildmann2
1Department of Medical Oncology, Medical Faculty Heidelberg, Section Translational Medical Ethics, National Center for Tumor Diseases, NCT Heidelberg, a partnership between DKFZ and Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.
Cancer medicine
|December 18, 2024
概括
为晚期癌症患者实施决策辅助 (DA) 需要平衡标准化与个人需求. 成功使用取决于医生支持,息护理教育和组织准备.
科学领域:
- 在瘤学瘤学.
- 医疗决策的制定 医疗决策的制定
- 医疗保健服务研究 医疗服务研究
背景情况:
- 决策辅助工具 (DA) 的目的是赋予患者在医疗保健选择中的权力.
- 针对晚期癌症治疗决策实施DA提出了独特的挑战.
- 本研究探讨了提供者对DA实施因素的观点.
研究的目的:
- 确定阻碍和促进因素,为晚期癌症患者实施可定制的决策辅助 (DA).
- 了解瘤学家和医疗保健专业人员对DA在临床实践中的使用的看法.
主要方法:
- 与瘤学家和医疗保健专业人员进行的半结构面试和焦点小组的定性内容分析.
- 包括来自DA开发和实施过程评估的见解.
- 分析了来自研究项目关于晚期癌症决策的两个数据集.
主要成果:
- 在标准化DA使用和个性化患者护理之间存在一个关键的紧张关系,通过灵活的两部分DA设计来解决这个问题.
- 成功实施DA的基本先决条件包括高级医生支持,息护理教育和支持性的组织条件.
- 瘤学家强调了影响DA成功的内容相关和结构因素.
结论:
- 对于晚期癌症的DA成功实施,需要解决援助的内容和结构/组织因素.
- 虽然内容问题被整合到DA开发中,但组织方面在实施过程中需要集中注意力.
- 提供者洞察力对于优化DA整合到先进的癌症护理至关重要.
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