Potential for identification of memory problems in the cancer clinic to enable improved treatment experience and outcomes: Mixed methods case study research
Potential for identification of memory problems in the cancer clinic to enable improved treatment experience and outcomes: Mixed methods case study research
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DOI：
10.1016/j.ejon.2020.101777
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发表时间：
2020-10-01
影响因子：
2.8
通讯作者：
Elias, Jayne
中科院分区：
文献类型：
--
作者：
Hopkinson, Jane;King, Amanda;Elias, Jayne
目的：为痴呆症或轻度认知障碍患者提供改善癌症治疗经验和结果的信息。与那些没有痴呆症的人相比，经历更多的癌症治疗的副作用，并有较差的结果，包括较差的survival.Methods：这项研究是一个混合的方法探索性的案例研究。每个病例都是对患有记忆丧失的人进行的癌症治疗，记忆丧失是痴呆症的常见症状。在2014年9月至2015年2月期间，在一家癌症中心的30个诊所进行了观察。有记忆问题的人和一名工作人员之间的33次接触被观察到，10次咨询被记录下来。采访了五名工作人员和六名接受癌症治疗的人，其中五人由他们的照顾者陪同。分析，由解释学现象学告知，使治疗途径被映射和建模，以揭示网站intervention.Findings：五个潜在的干预网站被确定在治疗途径。在干预地点采取的五项行动可能会改善患者的体验和结果，包括提高对接受癌症治疗的认知障碍患者常见问题的认识，鼓励披露记忆问题，培训工作人员识别记忆问题并知道该怎么做，提供工具和技术以帮助记忆问题的自我管理，以及解决照顾者的支持需求。将癌症的生物医学治疗嵌入痴呆友好的心理社会系统中，可以为更多患有痴呆症或轻度认知障碍的人提供安全的癌症治疗。
Purpose: To inform improvement in cancer treatment experience and outcomes for people with dementia or milder cognitive impairment. People with dementia, compared to those without, experience more side effects from cancer treatment and have poorer outcomes including poorer survival.Methods: The research was a mixed methods exploratory case study. Each case was a cancer treatment in a person with memory loss, a common symptom of dementia. Observations were conducted in 30 clinic sessions at one cancer centre between September 2014 and February 2015. Thirty-three encounters between people with a memory problem and a staff member were observed and ten consultations recorded. Interviews were conducted with five staff members and six people receiving cancer treatment, five accompanied by their carer. Analysis, informed by hermeneutic phenomenology, enabled the treatment pathway to be mapped and modelled to reveal sites for intervention.Findings: Five potential sites of intervention were identified in the treatment pathway. Five actions at the sites of intervention that may improve patient experience and outcomes include, raising awareness of common problems for people with cognitive impairment receiving cancer treatment, encouraging disclosure of memory problems, staff training to identify memory problems and to know what to do, offering tools and techniques to aid self-management of memory problems, and addressing carer support needs.Conclusion: Embedding biomedical treatment of cancer within a dementia-friendly psychosocial system may enable safe cancer treatment for a greater number of people with dementia or milder cognitive impairment.