Using mixed methods for evaluating an integrative approach to cancer care: A case study
Using mixed methods for evaluating an integrative approach to cancer care: A case study
复制标题
DOI：
10.1177/1534735407313395
复制
发表时间：
2008-03-01
影响因子：
2.9
通讯作者：
Moravan, Veronika
中科院分区：
文献类型：
--
作者：
Brazier, Alison;Cooke, Karen;Moravan, Veronika
Objective.评价参与不列颠哥伦比亚省温哥华综合治疗中心的综合癌症护理计划对患者生活方式、生活质量和整体健康的影响。研究设计.一个混合方法的案例研究与前测和后测设计。未使用对照组。方法. 2004年5月至9月间在综合治疗中心开始的所有新患者都被邀请参加这项研究。77例新患者中有46例同意参加。测量生活质量，社会支持，焦虑和抑郁，控制点和希望的定量数据进行了评估，在基线（预程序开始），并在6周和5个月的程序开始。以焦点小组和访谈的形式收集的定性数据，通过中途的后续阶段，以进一步探讨方案的影响。结果基线和5个月随访时间点之间的定量指标未观察到统计学显著改善或下降。定性研究结果揭示了患者积极参与癌症护理的主题，包括授权决策和创造个人改变。积极的病人参与自己的护理从综合方案的促进者包括与从业者，信息和资源，管理的补充和传统疗法，情感支持，希望感的整合愈合伙伴关系。讨论本案例研究是第一次尝试记录综合治疗中心综合癌症护理计划的影响。研究的局限性包括样本量小，这限制了检测问卷数量变化的能力，以及缺乏对照组。定性研究结果表明，病人发现价值的“以人为本”的整体护理方法，鼓励病人采取积极的作用，在决策和自我护理。使用混合方法的研究设计被证明是一种有效的方法，不仅评估结果，但也检查过程中的问题的经验。非常需要进一步的研究，以更好地了解综合方法对癌症护理的潜在影响。
Objective. To evaluate the impact of participating in an integrative cancer care program at the Centre for Integrated Healing in Vancouver, British Columbia, on patients' lifestyle, quality of life, and overall well-being. Study Design. A mixed-methods case study with a pre- and posttest design. No control group was utilized. Methods. All new patients starting at the Centre for Integrated Healing between May and September of 2004 were invited to join the study. Forty-six of 77 new patients agreed to participate. Quantitative data measuring quality of life, social support, anxiety and depression, locus of control, and hope were assessed at baseline (preprogram start) and at 6 weeks and 5 months from the start of the program. Qualitative data in the form of focus groups and interviews were collected midway through the follow-up period to further explore program impacts. Results. No statistically significant improvements or declines were noted on the quantitative measures between baseline and the 5-month follow-up point. The qualitative findings revealed a theme of patients' active engagement in their cancer care involving empowered decision making and creating personal change. Facilitators of active patient engagement in their own care from the integrative program included healing partnerships with practitioners, information and resources, managing the integration of complementary and conventional therapies, emotional support, and a sense of hope. Discussion. This case study was a first attempt at documenting the impact of an integrative cancer care program at the Centre for Integrated Healing. Study limitations included a small sample size, which limited power to detect quantitative changes on the questionnaires and a lack of a control group. Qualitative findings indicated that patients found value in the "person-oriented" holistic approach to care, which encouraged patients to take an active role in decision making and self-care. The use of a mixed-methods research design proved to be an effective approach to not only evaluating outcomes but also examining process issues of the experience. Additional research is greatly needed to better understand potential impacts of integrative approaches to cancer care.