The Perceived Facilitators and Challenges of Translating a Lung Cancer Palliative Care Intervention Into Community-Based Settings.
The Perceived Facilitators and Challenges of Translating a Lung Cancer Palliative Care Intervention Into Community-Based Settings.
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DOI：
10.1097/njh.0000000000000470
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发表时间：
2018-08
期刊：
影响因子：
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通讯作者：
Winslow B
中科院分区：
文献类型：
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作者：
Siler S;Mamier I;Winslow B
尽管在实施癌症患者姑息治疗干预方面取得了重大进展，但很少有干预研究在社区实施这些干预之前寻求医疗保健临床医生的投入。本研究的目的是探讨姑息治疗和肿瘤学临床医生的看法，认为促进者和挑战，在满足生活质量的需求，肺癌患者和家庭照顾者在社区为基础的设置。实施研究的RE-AIM模型被用作一个框架。这是一个多地点的定性研究，采用焦点小组和关键线人访谈。19名临床医生讨论了以下领域的有益做法和挑战：（a）早期姑息治疗;（B）跨学科护理规划;（c）症状管理;（d）满足心理和社会需求;（e）提供尊重文化的护理，包括精神护理。在准备干预措施的过程中，揭示了具体的教育需求和组织挑战。挑战包括时间和人员配置的限制，需要对姑息治疗服务的临床医生教育，以增加组织的购买，并在为患者和家庭照顾者提供精神支持的教育。这项研究使调查人员了解临床医生的看法，因为他们准备在他们的设置整合姑息治疗。临终关怀和姑息治疗护士可以在实施姑息治疗到社区实践中发挥作用。
Despite significant progress in implementing palliative care interventions for cancer patients, few intervention studies seek healthcare clinicians’ input prior to implementation of these into the community. The purpose of this study was to explore palliative care and oncology clinicians’ perspectives on the perceived facilitators and challenges in meeting the quality of life needs of lung cancer patients and family caregivers in community-based settings. The RE-AIM model for implementation research was used as a framework. This was a multi-site qualitative study using focus group and key informant interviews. Nineteen clinicians addressed useful practices and challenges in the following areas: (a) early palliative care; (b) interdisciplinary care planning; (c) symptom management; (d) addressing psychological and social needs; and (e) providing culturally respectful care, including spiritual care. In preparation for the intervention, specific education needs and organizational challenges were revealed. Challenges included timing and staffing constraints, the need for clinician education on palliative care services to increase organizational buy-in, and education in providing spiritual support for patients and family caregivers. This research allowed investigators to understand perceptions of clinicians as they prepared to integrate palliative care in their settings. Hospice and palliative care nurses can be instrumental in implementing palliative care into community practice.