有效地解决患者的优先事项和担忧仍然是肿瘤学的挑战。以患者为中心的护理(PCC)的系统化操作可以支持在这种独特的护理环境中改进PCC的评估和实践。这篇综述旨在综合探索美国国家医学科学院(NAM)PCC价值观结构的定性实证文献,需要,以及患者在癌症治疗期间的偏好。
2002年至2018年发表的针对成人患者价值的定性研究的系统综述需要,和癌症治疗期间的偏好进行。Medline,EMBASE,PsycINFO,和SCOPUS数据库于2018年9月10日进行了搜索。使用改进版本的定性研究评估工具评估方法的严谨性。使用逐行编码分析了纳入的研究结果;并将紧急主题与美国国家医学院(NAM)的PCC维度进行了比较。
合成中包括29项主要研究。价值观的描述性主题(自主性,参与其中,家庭,希望,常态,和真诚),需求(护理协调,信息,隐私,支持身体健康,情感支持(家人/朋友,同行,提供者),和自我支持),和偏好(护理协调,决策,信息传递,社会支持的来源,和治疗)被确定。“癌症护理背景”作为一个重要的领域出现了,在其中这些构建体被操作。该主题框架概述了肿瘤护理利益相关者可以评估的PCC属性,以改善患者体验。
这些发现建立在以往PCC研究的基础上,可能有助于从患者角度对患者优先事项进行系统评估,并改善肿瘤护理质量。
Efficiently addressing patient priorities and concerns remains a challenge in oncology. Systematic operationalization of patient-centered care (PCC) can support improved assessment and practice of PCC in this unique care setting. This
review aimed to synthesize the qualitative empirical literature exploring the National Academy of Medicine (NAM)\'s PCC constructs of values, needs, and preferences among patients\' during their cancer treatment experiences.
A systematic
review of qualitative studies published between 2002 and 2018 addressing adult patient values, needs, and preferences during cancer treatment was conducted. Medline, EMBASE, PsycINFO, and SCOPUS databases were searched on September 10, 2018. Methodological rigor was assessed using a modified version of the Evaluation Tool for Qualitative Studies. Included study findings were analyzed using line-by-line coding; and the emergent themes were compared to the National Academy of Medicine (NAM)\'s PCC dimensions.
Twenty-nine primary studies were included in the synthesis. Descriptive themes for values (autonomy, being involved, family, hope, normality, and sincerity), needs (care coordination, information, privacy, support of physical well-being, emotional support (family/friends, peer, provider), and self-support), and preferences (care coordination, decision-making, information delivery, source of social support, and treatment) were identified. \"Cancer care context\" emerged as an important domain in which these constructs are operationalized. This thematic framework outlines PCC attributes that oncology care stakeholders can evaluate to improve patient experiences.
These findings build on previous PCC research and may contribute to the systematic assessment of patient priorities and the improvement of oncology care quality from the patient perspective.