Promoting evidence-based psychosocial care for cancer patients
Promoting evidence-based psychosocial care for cancer patients
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DOI：
10.1002/pon.1468
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发表时间：
2009-01-01
期刊：
影响因子：
3.6
通讯作者：
Jacobsen, Paul B.
中科院分区：
文献类型：
--
作者：
Jacobsen, Paul B.
许多研究表明，心理社会护理可以减少痛苦，提高生活质量，从业人员有义务以符合这一证据的方式治疗癌症患者。虽然基本原理很简单，但在实现将研究转化为临床实践的目标方面存在重大挑战。一个挑战是证据的性质，许多心理社会干预研究的特点是方法质量差，缺乏资格标准，具体说明加剧的痛苦，并很少考虑传播的潜力。第二个挑战是使从业人员了解相关证据。有针对性的传播工作，如发布临床实践指南和循证建议以及通过互联网分发干预材料，在向从业人员提供有用信息方面似乎比被动的努力更有效。也许最具挑战性的方面是说服从业者改变他们的实践方式。目前正在开发的一种方法是，允许从业人员和保健组织根据对病历的审查，对其心理社会护理的质量进行自我评价。显示护理质量不佳的反馈可能会促使改变，特别是如果评估的质量指标被认为是重要和可靠的，并指出可以采取的具体行动。使用证据来促进临床实践的变化是心理肿瘤学领域充分发挥其潜力，积极影响癌症患者生活的主要方式之一。版权所有（c）2008约翰威利父子有限公司。
With numerous studies demonstrating that psychosocial care reduces distress and improves quality of life, practitioners have an obligation to treat cancer patients in a manner consistent with this evidence. Although the rationale is straightforward, major challenges exist in achieving the goal of translating research into clinical practice. One challenge has been the nature of the evidence, with many studies of psychosocial interventions characterized by poor methodological quality, absence of eligibility criteria specifying heightened distress, and minimal consideration of dissemination potential. A second challenge has been to make practitioners aware of relevant evidence. Targeted efforts at dissemination, such as the issuance of clinical practice guidelines and evidence-based recommendations and the distribution of intervention materials via the Internet, appear to be more effective than passive efforts in providing practitioners with useful information. Perhaps the most challenging aspect has been to persuade practitioners to change how they practice. One approach currently under development would allow practitioners and health-care organizations to perform self-evaluations of the quality of their psychosocial care based on review of medical records. Feedback showing quality of care to be less than optimal is likely to motivate change, especially if the quality indicators assessed are considered to be important and reliable and point to specific actions that can be taken. The use of evidence to promote changes in clinical practice represents one of the major ways in which the field of psycho-oncology can fully realize its potential to positively affect the lives of people with cancer. Copyright (c) 2008 John Wiley & Sons, Ltd.