如何确保晚期癌症患者获得高质量的信息和沟通

IF 3.8 3区 医学 Q1 NURSING
Zhijie Hu
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引用次数: 0

摘要

Rabben等人(2025)调查了晚期癌症患者及其家庭照顾者对姑息治疗共同决策的看法和经验。研究人员通过定性访谈确定了五个关键主题:(1)治疗方案与关键的生死决定有着内在联系,强调了它们的重要性;(2)患者和护理人员对参与决策的期望和偏好存在差异;(3)受情绪挑战和制度障碍的影响,共同决策的可行性和范围存在不确定性;(4)获得高质量的信息和有效的沟通被认为对有意义的参与至关重要;(5)护士在决策过程中的角色没有明确界定。研究结果强调了在姑息治疗中加强包容性沟通战略的关键必要性。我们就如何确保为晚期癌症患者提供高质量的信息和交流提出了不同的观点。最初,医疗保健专业人员必须评估信息需求,认知能力和偏好的每一个病人关于他们参与决策。针对这些特定因素量身定制讨论可以提高参与度,并帮助患者和护理人员浏览复杂的医疗信息。关于预后、治疗方案和预期结果的公开、诚实和富有同情心的对话对于建立信任和促进知情选择至关重要。患者及其家庭护理人员参与的结构化和连贯的对话促进了共同理解,减少了歧义并改善了协作决策。此外,各个学科之间的合作至关重要;护士、社会工作者和姑息治疗专家的参与促进了一种全面的方法,并确保在护理团队中保持一致的沟通。临床医生必须记录患者的价值观、目标和护理偏好,并将这些因素纳入治疗计划,以确保与个人优先事项保持一致。这种以患者为中心的沟通模式对于提供卓越的姑息治疗和改善整体护理体验至关重要。其次,护士在促进晚期癌症患者有效的信息交流和沟通方面至关重要。他们具有独特的能力来评估患者对医疗信息的理解,阐明复杂的概念,并解决情感和信息需求,由于他们的持续存在和与患者和家属的牢固治疗关系。通过在病床旁的持续参与,护士能够及早发现潜在问题,并迅速将其传达给多学科团队,从而促进及时和协调的护理。有效的沟通能力——比如积极倾听、移情参与和文化意识——对于建立信任和促进协作决策至关重要。护士是病人和医生之间的重要纽带,使重要信息得以流动,将医学术语翻译成可理解的语言,并倡导符合病人价值观和目标的护理。全面的文件和细致的轮班交接保证了信息的连续流动和可靠性。概述的贡献对于在复杂的临床环境中提供以患者为中心的高质量姑息治疗至关重要。第三,家庭照顾者在促进晚期癌症患者有效沟通和信息交流方面发挥着至关重要的作用。他们经常充当中间人,帮助患者理解复杂的医疗信息,提出问题,阐明个人价值观和护理偏好。家庭成员通过参与医疗咨询、记录信息和提出询问,为知情决策和支持患者偏好做出重大贡献。家庭照顾者除了提供实际帮助外,还提供情感支持,培养安全感,并加强患者与医疗保健专业人员之间的公开沟通。家庭照顾者应被视为护理团队的重要组成部分。临床医生应该让患者参与讨论,提供清晰及时的信息,促进共情沟通。对护理人员进行有关疾病进展、治疗风险和益处以及症状管理的教育,可提高他们有效提供服务的能力。他们的参与有助于患者,加强护理协调,并在姑息治疗环境中促进以患者为中心的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
How to Ensure High-Quality Information and Communication for People With Advanced Cancer

Rabben et al. (2025) investigated the perceptions and experiences of individuals with advanced-stage cancer and their family caregivers regarding shared decision-making in palliative care. Five key themes were identified by the researchers through qualitative interviews: (1) treatment options are intrinsically connected to critical life-and-death decisions, underscoring their importance; (2) patients and caregivers expressed varied expectations and preferences regarding their participation in decision-making; (3) uncertainty existed regarding the practicality and scope of shared decision-making, affected by emotional challenges and systemic obstacles; (4) access to high-quality information and effective communication was considered vital for meaningful engagement and (5) the role of nurses in the decision-making process was not clearly delineated. The findings highlight the critical necessity for enhanced, inclusive communication strategies within palliative care. We present various viewpoints on ensuring the provision of high-quality information and communication for individuals facing advanced cancer.

Initially, healthcare professionals must evaluate the informational requirements, cognitive abilities and preferences of each patient regarding their participation in decision-making. Tailoring discussions to these particular factors enhances engagement and helps patients and caregivers navigate complex medical information. Open, honest and compassionate conversations about prognosis, treatment options and expected outcomes are essential for building trust and facilitating informed choices. Structured and coherent conversations that involve both patients and their family caregivers promote shared understanding, reduce ambiguity and improve collaborative decision-making. Moreover, collaboration across various disciplines is crucial; engaging nurses, social workers, and palliative care specialists fosters a holistic approach and ensures that communication remains consistent within the care team. It is essential for clinicians to record patients' values, goals and care preferences, integrating these elements into treatment planning to guarantee alignment with individual priorities. This model of communication focused on the patient is essential for providing exceptional palliative care and improving the overall care experience.

Second, nurses are essential in facilitating effective information exchange and communication for patients with advanced cancer. They possess a distinctive ability to evaluate patients' understanding of medical information, elucidate intricate concepts and address both emotional and informational requirements, owing to their ongoing presence and strong therapeutic relationships with patients and families. Through consistent engagement at the bedside, nurses are able to identify potential issues early and relay them swiftly to the multidisciplinary team, thus promoting timely and coordinated care. Effective communication abilities—like active listening, empathetic engagement, and cultural awareness—are crucial for building trust and facilitating collaborative decision-making. Nurses serve as essential connections between patients and doctors, enabling the flow of vital information, translating medical terminology into understandable language and advocating for care that aligns with patients' values and objectives. Comprehensive documentation and meticulous shift handovers guarantee the continuous flow and dependability of information. The contributions outlined are essential for providing patient-centred, high-quality palliative care in intricate clinical settings.

Third, family caregivers play a crucial role in promoting effective communication and information exchange for individuals with advanced cancer. They often act as intermediaries, assisting patients in comprehending complex medical information, formulating questions and articulating personal values and care preferences. Family members significantly contribute to informed decision-making and the support of patient preferences by participating in medical consultations, documenting information, and posing inquiries. Family caregivers offer emotional support alongside practical assistance, fostering a sense of security and enhancing open communication between patients and healthcare professionals. Family caregivers should be recognised as vital components of the care team. Clinicians should engage patients in discussions, provide clear and timely information and facilitate empathetic communication. Educating caregivers regarding disease progression, treatment risks and benefits and symptom management enhances their ability to contribute effectively. Their involvement aids patients, enhances care coordination, and fosters patient-centred outcomes in palliative settings.

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来源期刊
CiteScore
6.40
自引率
7.90%
发文量
369
审稿时长
3 months
期刊介绍: The Journal of Advanced Nursing (JAN) contributes to the advancement of evidence-based nursing, midwifery and healthcare by disseminating high quality research and scholarship of contemporary relevance and with potential to advance knowledge for practice, education, management or policy. All JAN papers are required to have a sound scientific, evidential, theoretical or philosophical base and to be critical, questioning and scholarly in approach. As an international journal, JAN promotes diversity of research and scholarship in terms of culture, paradigm and healthcare context. For JAN’s worldwide readership, authors are expected to make clear the wider international relevance of their work and to demonstrate sensitivity to cultural considerations and differences.
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