Assessing Needs and Experiences of Preparing for Medical Emergencies Among Children With Cancer and Their Caregivers.
Assessing Needs and Experiences of Preparing for Medical Emergencies Among Children With Cancer and Their Caregivers.
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评估癌症儿童及其护理人员的医疗紧急情况的需求和经验。
DOI：
10.1097/mph.0000000000001826
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发表时间：
2020-11
期刊：
影响因子：
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通讯作者：
Wiehe SE
中科院分区：
文献类型：
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作者：
Mueller EL;Cochrane AR;Moore CM;Jenkins KB;Bauer NS;Wiehe SE
癌症儿童的照顾者在急诊科寻求治疗时可能会遇到压力。我们试图评估护理人员如何为社区环境中出现的医疗紧急情况做好准备和管理。使用自报互动工具包对癌症儿童及其照顾者的急诊科(ED)就诊准备进行定性评估。符合条件的参与者包括目前正在接受癌症诊断治疗的癌症儿童(年龄11-21岁)，以及在过去2个月内接受急诊室就诊(除初步诊断外)的患者和照顾者。参与者收到了一个纸质工具包，这些工具包被组织成带有几个生成性活动的经验地图。使用NVivo 12.0软件对工具包进行转录、主题编码和迭代分析。总共收到了25个工具包(7名儿童，18名照顾者)，大约四分之三的参与者居住在距离治疗机构1小时以上的地方。出现了几个重要的共同主题和需要改进的领域。主题包括在何时何地寻求急诊室护理的决策方面的斗争，准备去急诊室，在急诊室就诊期间等待，向多个提供者重复信息，访问端口，以及提供者对提供者和提供者对护理者/患者的沟通。从这项研究中获得的信息有可能成为支持这一人群规划和管理紧急医疗问题的工具。这一工具有可能提高患者和照顾者的满意度、以患者为中心的结果和临床结果。
Caregivers of children with cancer can experience stress when seeking care in the emergency department. We sought to assess how caregivers prepare for and manage a medical emergency that arises in the community setting. A qualitative evaluation of emergency department (ED) visit preparations taken by children with cancer and their caregivers using self-reported interactive toolkits. Eligible participants included children with cancer (age 11 – 21) currently receiving therapy for a cancer diagnosis with an ED visit (besides initial diagnosis) within the previous 2 months and caregivers of same. Participants received a paper toolkit, which were structured as experience maps with several generative activities. Toolkits were transcribed, thematically coded, and iteratively analyzed using NVivo 12.0 software. A total of 25 toolkits were received (7 children, 18 caregivers), with about three-quarters of participants living greater than 1 hour from the treating institution. Several important common themes and areas for improvement emerged. Themes included struggles with decision-making regarding when and where to seek ED care, preparing to go to the ED, waiting during the ED visit, repetition of information to multiple providers, accessing of ports, and provider-to-provider and provider-to-caregiver/patient communication. The information gained from this study has the potential to inform a tool to support this population in planning for and managing emergent medical issues. This tool has the potential to improve patient and caregiver satisfaction, patient centered outcomes, and clinical outcomes.