The codesign of an interdisciplinary team-based intervention regarding initiating palliative care in pediatric oncology.
The codesign of an interdisciplinary team-based intervention regarding initiating palliative care in pediatric oncology.
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DOI：
10.1007/s00520-018-4190-5
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发表时间：
2018-09
期刊：
影响因子：
--
通讯作者：
Feudtner C
中科院分区：
文献类型：
--
作者：
Hill DL;Walter JK;Casas JA;DiDomenico C;Szymczak JE;Feudtner C
患有晚期癌症的儿童在死前通常不会被转介到姑息治疗或临终关怀，或者只在孩子接近死亡时才被转介。当前项目的目标是了解儿科肿瘤学团队成员对姑息治疗的看法，与团队成员合作修改和定制三种不同的跨学科团队干预措施，以启动姑息治疗，并评估这种合作方法的可行性。我们使用了一种改进版的基于经验的协同设计（EBCD），涉及儿童姑息治疗团队和三个跨学科儿童肿瘤团队（骨髓移植、神经肿瘤学和实体肿瘤）的成员，以审查和定制三种基于团队的干预措施的材料。11名儿科肿瘤学团队成员参加了四次共同设计会议，讨论了他们在启动姑息治疗方面的经验，并回顾了拟议的干预措施，包括：患者案例研究、管理不确定性和负面情绪的技术、角色模糊、系统级障碍以及团队沟通和协作。共同设计过程表明，参与者是姑息治疗的坚定支持者，不同团队的成员对适合他们团队的不同材料有不同的偏好，尽管参与者对姑息治疗的时机感到沮丧，但他们很难提出如何改变目前的做法。目前的项目证明了与儿科肿瘤学临床医生合作开发引入姑息治疗的干预措施的可行性。该项目的程序和结果将在网上公布，以便其他机构可以将其作为模型，制定适合其需要的类似干预措施。
Children with advanced cancer are often not referred to palliative or hospice care before they die or are only referred close to the child’s death. The goals of the current project were to learn about pediatric oncology team members’ perspectives on palliative care, to collaborate with team members to modify and tailor three separate interdisciplinary team-based interventions regarding initiating palliative care, and to assess the feasibility of this collaborative approach. We used a modified version of Experience Based Codesign (EBCD) involving members of the pediatric palliative care team and three inter-disciplinary pediatric oncology teams (Bone Marrow Transplant, Neuro-Oncology, and Solid Tumor) to review and tailor materials for three team-based interventions. 11 pediatric oncology team members participated in four codesign sessions to discuss their experiences with initiating palliative care and to review the proposed intervention including: patient case studies, techniques for managing uncertainty and negative emotions, role ambiguity, system-level barriers, and team communication and collaboration. The codesign process showed that the participants were strong supporters of palliative care, members of different teams had preferences for different materials that would be appropriate for their teams, and that while participants reported frustration with timing of palliative care, they had difficulty suggesting how to change current practices. The current project demonstrated the feasibility of collaborating with pediatric oncology clinicians to develop interventions about introducing palliative care. The procedures and results of this project will be posted online so that other institutions can use them as a model for developing similar interventions appropriate for their needs.
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影响因子：
2.4
作者：
Amador S;Goodman C;Mathie E;Nicholson C
通讯作者：
Nicholson C
影响因子：
4.4
作者：
Fortney, Luke;Luchterhand, Charlene;Rakel, David
通讯作者：
Rakel, David
影响因子：
3.1
作者：
Johnston, Donna L.;Vadeboncoeur, Christina
通讯作者：
Vadeboncoeur, Christina
DOI：
10.1177/1049909116681972
发表时间：
2018-01-01
影响因子：
1.9
作者：
Brown, Crystal E.;Back, Anthony L.;Engelberg, Ruth A.
通讯作者：
Engelberg, Ruth A.
影响因子：
3.2
作者：
Clarke, Jean;Quin, Suzanne
通讯作者：
Quin, Suzanne