Support for Patients and Family Caregivers in Lung Cancer: Educational Components of an Interdisciplinary Palliative Care Intervention.
Support for Patients and Family Caregivers in Lung Cancer: Educational Components of an Interdisciplinary Palliative Care Intervention.
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DOI：
10.1097/njh.0000000000000165
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发表时间：
2015-08
期刊：
影响因子：
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通讯作者：
Buga S
中科院分区：
文献类型：
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作者：
Borneman T;Sun V;Williams AC;Fujinami R;Del Ferraro C;Burhenn PS;Irish T;Zachariah F;van Zyl C;Buga S
根据医学研究所关于高质量癌症护理的报告的建议，应在整个疾病发展轨迹中关注肺癌患者的症状管理和生活质量问题。作为NCI资助的项目资助项目的一部分，本文报告了针对早期(I-III，n=130)和晚期(IV，n=142)肺癌患者的护士主导的、量身定制的姑息治疗干预的患者和家庭照顾者教育部分。患者和家庭照顾者接受了围绕生活质量模型领域(生理、心理、社会和精神健康)组织的4个单独的教育会议。每名患者和照顾者都参加了每周一次的跨学科病例会议，这也为教育会议提供了信息。根据需求和团队建议，创建了个性化的姑息护理计划，并根据每个参与者选择的主题设计了量身定制的教育干预措施。患者在每个领域选择的最常见的话题是疲劳、担忧和恐惧、社会支持/孤立和希望。家庭照顾者最常见的选择是疲劳、担忧和恐惧、沟通、以及生活的目标和意义。患者每次授课的平均时间从31到44分钟不等，家庭照顾者的平均时间从25到35分钟不等。迫切需要为所有阶段和疾病轨迹的患者提供跨学科的姑息治疗干预。护士是将姑息治疗与常规护理相结合的关键。提供量身定制的教育干预是为患者和家庭照顾者提供姑息治疗的一个重要方面。本文重点研究了量身定做的教育干预过程。
Consistent with the recommendations of the Institute of Medicine Report on quality cancer care, attention to symptom management and quality of life concerns of patients with lung cancer should be addressed throughout the disease trajectory. As part of a NCI-funded Program Project grant, this paper reports on the patient and family caregiver education component of a nurse-lead, tailored palliative care intervention for patients with early (I–III, n=130) and late (IV, n=142) stage lung cancer. Patients and family caregivers received 4 separate educational sessions organized around the Quality of Life model domains (physical, psychological, social, and spiritual well-being). Each patient and caregiver was presented at a weekly interdisciplinary case conference which also informed the educational sessions. Based on needs and team suggestions, an individualized palliative care plan was created and a tailored educational intervention was designed based on topics chosen by each participant. The most common topics chosen by patients in each domain were fatigue, worry and fear, social support/isolation, and hope. Family caregivers most commonly chose fatigue, worry and fear, communication, and purpose and meaning in life. The mean time spent in each teaching session ranged from 31 to 44 minutes for patients and 25 to 35 minutes for family caregivers. There is a vital need for interdisciplinary palliative care interventions for patients across all stages and across the disease trajectory. Nurses are vital to integrating palliative care into routine care. Providing a tailored educational intervention is an important aspect of palliative care for patients and family caregivers. This paper focuses on the process of the tailored educational intervention.