Supporting cancer family caregivers: How can frontline oncology clinicians help?
Supporting cancer family caregivers: How can frontline oncology clinicians help?
复制标题
支持癌症家庭护理人员：一线肿瘤临床医生如何提供帮助？
DOI：
10.1002/cncr.30759
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发表时间：
2017
期刊：
影响因子：
6.2
通讯作者：
Dionne-Odom,JNicholas
中科院分区：
文献类型：
--
作者：
Porter,LauraS;Dionne-Odom,JNicholas
最近一波研究优先共识论文，临床指南和组织报告，包括国家科学院（前身为医学研究所）的一份报告，都反映了一个共同的主题：我们迫切需要转变对280万无偿照顾癌症患者的家庭成员的支持。1-4国家研究院的报告详细介绍了支持这些家庭照顾者所需的许多系统层面的变化，如政策和支付改革以及员工休假和社会服务的变化。在目前的制度下，临床医生解决照顾者的问题，包括时间不足，有限的报销机制，并在及时获得专家服务（如姑息治疗）的困难，有巨大的障碍。3然而，如果没有消费者（即护理人员本身）的需求激增，系统层面的变化就不太可能发生。这就提出了一个重要的问题：一线肿瘤学临床医生，包括医生，执业护士，心理学家，护士，社会工作者，个案管理人员，和其他人，在他们的临床接触，以授权，参与和支持家庭照顾者实际上可以做什么？当我们看到目前在临床医生层面上发生的支持家庭护理人员的事情时，改进的空间是巨大的。全国护理联盟2015年的一项全国调查发现，只有1/2的癌症护理人员被医疗保健专业人员询问过他们需要什么。当他们被问及，照顾者报告的需求是众多和复杂的。5但奇怪的是，照顾者往往不会说出这些需求，虽然有些照顾者积极主动地寻求服务，但大多数人不会。6许多人被自己的责任压得喘不过气来。另一些人则忽视了自己的需要，因为他们认为护理的重点应该仅仅放在病人身上。7即使医疗保健提供者确实询问他们的需求或他们如何应对，许多护理人员也会询问他们的需求。
A recent wave of research priority consensus papers, clinical guidelines, and organizational reports including one by the National Academy (formerly the Institute of Medicine) resound with a common theme: there is an urgent need for a transformation in the support we give to the 2.8 million unpaid family members caring for our patients with cancer. 1–4 The National Academy report details many of the system-level changes that will be necessary to support these family caregivers such as policy and payment reform and changes to employee leave and social services. Under the current system, there are formidable barriers to clinicians addressing caregiver concerns, including insufficient time, limited reimbursement mechanisms, and difficulties in timely access to specialist services (eg palliative care). 3 However, system-level changes are unlikely to occur without a groundswell of demand from consumers, ie, the caregivers themselves. This raises an important question: What can frontline oncology clinicians–including physicians, nurse practitioners, psychologists, nurses, social workers, case managers, and others-realistically do in their clinical encounters to empower, engage, and support family caregivers?When we look at what is currently happening at the clinician-level to support family caregivers, the room for improvement is vast. A 2015 national survey by the National Alliance for Caregiving 1 found that only 1-in-2 cancer caregivers are ever asked by healthcare professionals what they need. When they are asked, caregivers report needs that are numerous and complex. 5 Paradoxically though, caregivers will often not vocalize these needs, and while some caregivers are proactive in seeking out services, most do not. 6 Many are overwhelmed with their caregiving responsibilities. Others dismiss their own needs due to the belief that the focus of care should remain solely on the patient. 7 Even when healthcare providers do ask them about their needs or how they are coping, many caregivers
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影响因子：
45.3
作者：
Ferrell, Betty R.;Temel, Jennifer S.;Smith, Thomas J.
通讯作者：
Smith, Thomas J.
影响因子：
6.2
作者：
Kent EE;Rowland JH;Northouse L;Litzelman K;Chou WY;Shelburne N;Timura C;O'Mara A;Huss K
通讯作者：
Huss K
影响因子：
1.8
作者：
Acton, GJ
通讯作者：
Acton, GJ
影响因子：
3.9
作者：
Goldsmith, Daena J.;Miller, Gregory A.
通讯作者：
Miller, Gregory A.
影响因子：
120.7
作者：
Steinhauser, AE;Christakis, NA;Tulsky, JA
通讯作者：
Tulsky, JA