"Made Me Realize That Life Is Worth Living": A Qualitative Study of Patient Perceptions of a Primary Palliative Care Intervention.
"Made Me Realize That Life Is Worth Living": A Qualitative Study of Patient Perceptions of a Primary Palliative Care Intervention.
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“让我意识到生活是值得的”：患者对初级姑息治疗干预的看法的定性研究。
DOI：
10.1089/jpm.2021.0015
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发表时间：
2022
影响因子：
2.8
通讯作者：
Bekelman,DavidB
中科院分区：
文献类型：
--
作者：
Portz,JenniferDickman;Graney,BridgetA;Bekelman,DavidB
背景：需要初级姑息治疗来满足严重疾病患者及其家人的复杂需求。然而，患者对初级姑息治疗的看法还没有被很好地理解，并且可以为后续的初级姑息治疗干预和实施提供指导。目的：从患者的角度得出患者对初级姑息治疗干预的观点。设计：使用患者访谈和两种三角测量方法进行定性研究。地点/对象：2014年7月至2015年9月，我们采访了45名参与干预的美国患者，这些患者参加了退伍军人事务部(VA)(主要地点)、学术和城市安全网卫生系统的干预。主要措施：询问参与者什么是最有帮助的，什么是最不有用的，干预如何影响参与者的生活，以及干预应该做出哪些改变。使用一般归纳法对数据进行分析。结果：六个主题确定初级保健干预：(1)照顾我的心理社会需求，(2)鼓励自我管理，(3)用药建议有效，(4)促进目标实现，(5)团队有益，(6)良好的探视时间。结论：参与者从初级姑息干预中受益，并将这些益处归因于个性化的评估和支持，促进技能建设和自我管理，以及来自跨专业护理团队的监督。未来的初级姑息治疗干预可能受益于针对这些特定的患者价值过程。
Background:Primary palliative care is needed to meet the complex needs of patients with serious illness and their families. However, patient perceptions of primary palliative care are not well understood and can inform subsequent primary palliative care interventions and implementation.Objective:Elicit the patient perspective on a primary palliative care intervention, Collaborative Care to Alleviate Symptoms and Adjust to Illness (CASA), from patient perspectives.Design:Qualitative study using patient interviews and two methods of triangulation.Setting/Subjects:Between July 2014 and September 2015, we interviewed 45 patients who participated in the intervention in a Veterans Affairs (VA) (primary site), academic, and urban safety-net health system in the United States.Main Measures:Participants were asked about what was most and least helpful, how the intervention affected participants' lives, and what should be changed about the intervention. Data were analyzed using a general inductive approach. To enhance validity of the results, we triangulated the findings from patient interviews, reviews of care coordinator documentation, and interprofessional palliative care providers.Results:The six themes identified that primary care intervention: (1) Cared for My Psychosocial Needs, (2) Encouraged Self-Management, (3) Medication Recommendations Worked, (4) Facilitated Goal Attainment, (5) Team was Beneficial, and (6) Good Visit Timing.Conclusions:Participants experienced benefits from the primary palliative care intervention and attributed these benefits to individualized assessment and support, facilitation of skill building and self-management, and oversight from an interprofessional care team. Future primary palliative care interventions may benefit from targeting these specific patient-valued processes.