Understanding and identifying ways to improve hospital-based cancer care and treatment for people with dementia: an ethnographic study.
Understanding and identifying ways to improve hospital-based cancer care and treatment for people with dementia: an ethnographic study.
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DOI：
10.1093/ageing/afaa210
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发表时间：
2021-01-08
期刊：
影响因子：
6.7
通讯作者：
Surr C
中科院分区：
文献类型：
--
作者：
Ashley L;Kelley R;Griffiths A;Cowdell F;Henry A;Inman H;Hennell J;Ogden M;Walsh M;Jones L;Mason E;Collinson M;Farrin A;Surr C
为患有痴呆症等并发症的老龄人口提供癌症护理和治疗是一项日益严峻的全球挑战。这项研究旨在检查痴呆症患者在医院的癌症护理和治疗挑战和支持需求，并确定解决这些问题的潜在方法。一项在英格兰进行的两个地点的人种学研究，包括半结构化访谈、观察和伴随的对话，以及医疗记录审查。参与者(N= 58)是痴呆症和癌症共病患者(n= 17)，非正式照顾者(n= 22)和医院工作人员(n= 19)。进行了民族志知情的专题分析。同时患有两种疾病的情况有一种累积的复杂性。痴呆症患者及其家人可能会因为难以理解、保留和使用癌症信息而感到困惑和不知情，这影响了他们知情的治疗决策。痴呆症增加了前往和导航陌生医院环境的复杂性和负担，频繁地在医院长时间等待，以及在家中自我管理症状和副作用。肿瘤工作人员经常在没有全貌的情况下工作，因为在医疗记录中对痴呆症的记录多种多样，痴呆症培训有限，时间和资源压力阻碍了痴呆症患者所需的高度个性化、灵活的癌症护理。支持性的家庭照顾者在使痴呆症患者能够获得、导航和接受癌症治疗和护理方面至关重要。痴呆症通过癌症途径积累的一系列方式使癌症护理复杂化。我们的发现表明，有几种策略和干预措施有可能改善痴呆症患者及其家人的癌症护理和治疗，我们在这里列出了这些策略和干预措施。
Providing cancer care and treatment for ageing populations with complicating comorbidities like dementia is a growing global challenge. This study aimed to examine the hospital-based cancer care and treatment challenges and support needs of people with dementia, and identify potential ways to address these. A two-site ethnographic study in England involving semi-structured interviews, observations and accompanying conversations, and medical record review. Participants (N = 58) were people with dementia and comorbid cancer (n = 17), informal caregivers (n = 22) and hospital staff (n = 19). Ethnographically informed thematic analysis was conducted. There was an accumulated complexity of living with both illnesses simultaneously. People with dementia and families could feel confused and uninformed due to difficulties understanding, retaining and using cancer information, which impacted their informed treatment decision-making. Dementia increased the complexity and burden of travelling to and navigating unfamiliar hospital environments, frequent lengthy periods of waiting in hospital, and self-managing symptoms and side-effects at home. Oncology staff were often working without the full picture, due to variable documenting of dementia in medical records, dementia training was limited, and time and resource pressures impeded the highly individualised, flexible cancer care required by people with dementia. Supportive family carers were crucial in enabling people with dementia to access, navigate and undergo cancer treatment and care. Dementia complicates cancer care in a range of ways accumulating across the cancer pathway. Our findings suggest there are several strategies and interventions, which we list here, with potential to improve cancer care and treatment for people with dementia and their families.
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影响因子：
3
作者：
Surr CA;Kelley R;Griffiths AW;Ashley L;Cowdell F;Henry A;Collinson M;Mason E;Farrin AJ
通讯作者：
Farrin AJ
影响因子：
2.1
作者：
Iredale, R.;Hilgart, J.;Hayward, J.
通讯作者：
Hayward, J.
影响因子：
3.2
作者：
Witham, Gary;Haigh, Carol;Beddow, Anna
通讯作者：
Beddow, Anna
影响因子：
--
作者：
Nguyen, Hai;Manolova, Gergana;Prina, A Matthew
通讯作者：
Prina, A Matthew
影响因子：
2.9
作者：
McWilliams, Lorna;Farrell, Carole;Yorke, Janelle
通讯作者：
Yorke, Janelle