Informing the delivery of cancer survivorship care in rural primary care practice.
Informing the delivery of cancer survivorship care in rural primary care practice.
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DOI：
10.1007/s11764-021-01134-3
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Greiner KA
中科院分区：
文献类型：
--
作者：
Klemp JR;Knight CJ;Lowry B;Long T;Bush C;Alsman K;Krebill H;Peereboom D;Overholser L;Greiner KA
到2030年，癌症幸存者人口预计将增加到2220万，这需要改善肿瘤学和初级保健实践（PCP）之间的合作。在没有癌症专家的投入的情况下，PCP可能会觉得自己没有能力为患者提供癌症生存护理。与非农村癌症幸存者相比，农村癌症幸存者报告经历了更严重的治疗相关症状。本研究的目的是更好地了解PCP团队对生存护理的观点，并开发和测试跨学科的培训计划，以提高农村实践中的癌症生存护理。本研究分两个阶段进行。首先，焦点小组进行了农村PCP团队收集有关信仰，做法和障碍的信息，癌症生存护理提供。通过反复审查记录本的过程完成了专题分析。第一阶段的结果被用来为在七个农村PCP（第二阶段）中测试的试点干预措施的制定提供信息。干预前和干预后的知识变化进行了比较，和会后访谈评估计划或持续的做法的变化。7名项目协调员参加了重点小组（第1阶段）。确定的交叉主题包括（1）影响癌症生存护理提供的组织障碍，（2）专家和患者角色划分的挑战，（3）难以获得生存护理和资源，以及（4）提供者缺乏癌症生存护理知识。在第二阶段，七个做法参加了四个基于案例的教育会议。查明了做法内部和做法之间的变化。该项目探讨了PCP团队之间的癌症生存前景。在讨论中，缺乏对循证指南的熟悉以及无法识别癌症幸存者的情况很明显，导致实施了第二阶段干预措施iSurvive。因此，PCP改变或计划改变，以改善癌症幸存者的识别和循证护理。解决农村初级保健实践中获得癌症生存护理的障碍。
The cancer survivor population is projected to increase to 22.2 million by 2030, requiring improved collaboration between oncology and primary care practices (PCP). PCPs may feel ill-equipped to provide cancer survivorship care to patients without input from cancer specialists. Compared with nonrural cancer survivors, rural cancer survivors report experiencing worse treatment-related symptoms. The goal of this study was to gain a better understanding of the perspectives of PCP teams towards survivorship care and to develop and test an interdisciplinary training program to improve cancer survivorship care in rural practice. This study was conducted in two phases. First, focus groups were conducted with rural PCP teams to gather information regarding beliefs, practices, and barriers related to cancer survivorship care delivery. A thematic analysis was completed using an iterative process of reviewing transcripts. Results from phase 1 were used to inform the development of a pilot intervention tested within seven rural PCPs (phase 2). Pre- and post-intervention knowledge changes were compared, and post-session interviews assessed planned or sustained practice changes. Seven PCPs participated in focus groups (phase 1). Cross-cutting themes identified included (1) organizational barriers affecting the delivery of cancer survivorship care, (2) challenges of role delineation with specialists and patients, (3) difficulty accessing survivorship care and resources, and (4) providers’ lack of knowledge of cancer survivorship care. For phase 2, seven practices participated in four case-based educational sessions. Within and between practice changes were identified. This project explored cancer survivorship perspectives among PCP teams. Lack of familiarity with evidence-based guidelines and the inability to identify cancer survivors was apparent during discussions and led to the implementation of the phase 2 intervention, iSurvive. As a result, PCPs either changed or planned changes to improve the identification and evidence-based care of cancer survivors. Address barriers to access cancer survivorship care in rural primary care practices.
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影响因子：
51.1
作者：
Mayer, Deborah K.;Nasso, Shelly Fuld;Earp, Jo Anne
通讯作者：
Earp, Jo Anne
影响因子：
2.2
作者：
Dahlhaus, Anne;Vanneman, Nicholas;Siebenhofer, Andrea
通讯作者：
Siebenhofer, Andrea
影响因子：
--
作者：
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通讯作者：
Lynch, Charles F.
影响因子：
1.1
作者：
DeGuzman, Pam Baker;Colliton, Kaitlyn;Keim-Malpass, Jessica
通讯作者：
Keim-Malpass, Jessica
影响因子：
1.6
作者：
Grant, Marcia;Economou, Denice;Uman, Gwen
通讯作者：
Uman, Gwen