泰国南部老年癌症患者及其家庭成员参与预先护理计划的优势、障碍和线索:一项定性研究。

IF 2.5 2区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Supakorn Sripaew, Sawitri Assanangkornchai, Pawita Limsomwong, Rungarun Kittichet, Polathep Vichitkunakorn
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引用次数: 0

摘要

背景:老年癌症患者在癌症治疗期间很容易出现较差的健康状况。虽然泰国老年人对未来的医疗护理有自己的偏好,而且预先护理计划(ACP)可以帮助癌症患者做出明智的决定,但据泰国医生报告,预先护理计划的参与率很低。因此,本研究旨在探讨老年癌症患者及其家属对参与 ACP 的看法:我们采用定性方法探讨了年龄≥ 60 岁的非血液肿瘤患者及其主要照顾者的看法。研究在泰国南部宋卡那林医院肿瘤放疗转诊中心进行。对患者及其护理人员进行了半结构化深入访谈。采用主题分析法确定和分析访谈记录中有关参与 ACP 的反复出现的模式和主题:在接触的 138 个家庭中,共进行了 32 次访谈。结果发现了三个主题:(1) 有利的机会:患者认为 ACP 将帮助他们实现自己的人生价值,并确保他们的偏好得到尊重;(2) ACP 的思考和障碍:ACP 既陌生又不必要,可能效用低,会让患者和家属担心,失去乐观情绪,在目前的健康状况下对患者来说不是一项合适的活动;(3) 启动 ACP 的线索:认为符合自己的宗教信仰、了解目前的癌症状况、有多种并发症或经历过与医疗相关的痛苦、不希望给家人带来负担、有亲密的家人以及对医生的信任。结论老年患者和/或其家人的观念以及护理人员的沟通技巧可能会阻碍或促进参与 ACP。旨在启动 ACP 的专业护理人员应尽量减少潜在的障碍,突出 ACP 的益处,并注意提示开始 ACP 对话的有利时机。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Advantages, barriers, and cues to advance care planning engagement in elderly patients with cancer and family members in Southern Thailand: a qualitative study.

Background: Older cancer patients are vulnerable to poorer health outcomes during cancer treatment. Although the Thai elderly had their own preferences towards future medical care and advance care planning (ACP) could help cancer patients make informed decisions, Thai physicians report a low ACP engagement rate. Thus, this study aimed to explore the perceptions of older cancer patients and their families towards ACP engagement.

Method: We used a qualitative approach to explore the perceptions of non-haematological cancer patients aged ≥ 60 years old and their primary caregivers. The study was conducted at the Oncology Radiotherapy Referral Center, Songklagarind Hospital in Southern Thailand. Semi-structured in-depth interviews were conducted with the patients and their caregivers. Thematic analysis was used to identify and analyze recurring patterns and themes of perceptions regarding ACP engagement within the interview transcripts.

Results: Among the 138 families approached, 32 interviews were conducted. Three themes were found: (1) Advantageous opportunity: the patients believed ACP would help them realize their life values, and ensure that their preference would be respected; (2) contemplation and barriers to ACP: ACP is unfamiliar and unnecessary, might have low utility, worry patients and family members, take away optimism, would not be a proper activity for the patient at the current health situation; and (3) Cues for ACP initiation: perceived conformity with one's religion, awareness of the current cancer state, having multiple comorbidity or experience suffering related with medical care, wishing not to burden family, having close family members, and trust in physicians.

Conclusion: ACP engagement could be hindered or promoted by perceptions of older patients and/ or their family members, as well as the communication skills of the care providers. Care professionals who aim to initiate ACP should minimize the potential barriers, make the ACP benefits salient, and watch for cues indicating a propitious time to start the ACP conversation.

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来源期刊
BMC Palliative Care
BMC Palliative Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
4.60
自引率
9.70%
发文量
201
审稿时长
21 weeks
期刊介绍: BMC Palliative Care is an open access journal publishing original peer-reviewed research articles in the clinical, scientific, ethical and policy issues, local and international, regarding all aspects of hospice and palliative care for the dying and for those with profound suffering related to chronic illness.
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