谈判平躺和临床问题:在癌症护理中实施平躺导航计划。

Q1 Nursing
Laura M. Holdsworth, Dani L. Zionts, Suwei Wang, D. Veruttipong, C. Brown-Johnson, S. Asch, E. Rosenthal, M. Winget
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引用次数: 4

摘要

目的癌症患者在脆弱时期面临着令人生畏的协调问题。Lay导航程序提供了一种解决这些问题的方法,但如何最好地实施这些程序带来了挑战。我们试图描述1个癌症学术中心的实施挑战,为未来的努力提供信息。方法我们在项目启动一年后使用标准实施结果进行了一项混合方法研究。分析中包括来自电子病历的定量数据和来自深入访谈、焦点小组和民族志观察的定性数据。这项研究在国家癌症研究所指定的癌症综合中心进行,共有12个肿瘤特异性诊所。结果支持性护理问题、日程安排和临床相关问题是导航员遇到的最常见问题。有效的导航需要持续、耗时、无形的工作,包括建立和维护广泛的资源和卫生系统流程知识库,以及培养与多样化和不断变化的临床团队的关系。临床和社会工作人员对非专业导航活动的可接受性和适当性参差不齐,这与临床和非临床护理之间的协商线有关。结论经过一年的实施,非专业导航员仍然发现很难以所有临床工作人员都认为合适的方式解释和优先考虑复杂的患者需求。谈判这些问题使得很难与临床团队建立强有力的关系,而这种关系是患者护理综合方法所必需的。为了成功协调患者护理,似乎应该将lay导航程序与临床团队集成,以提供更无缝的患者护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Negotiating Lay and Clinical Issues: Implementing a Lay Navigation Program in Cancer Care.
PURPOSE Patients with cancer face daunting coordination problems at a vulnerable time. Lay navigation programs offer 1 approach to address these problems, but how to best implement these programs presents challenges. We sought to describe those implementation challenges at 1 academic cancer center to inform future efforts. METHODS We performed a mixed methods study using standard implementation outcomes 1 year after program initiation. Quantitative data from the electronic medical record and qualitative data from in-depth interviews, focus groups, and ethnographic observations were included in analyses. The study took place at a National Cancer Institute-designated comprehensive cancer center across 12 tumor-specific clinics. RESULTS Supportive care concerns, scheduling, and clinical-related issues were the most frequent issues navigators encountered. Effective navigation required continuous, time-consuming, invisible work, including building and maintaining a broad knowledge base of resources and health system processes, as well as cultivating relationships with diverse and changing clinical teams. The acceptability and appropriateness of lay navigator activities were mixed among clinic and social work staff, related to negotiating lines between clinical and nonclinical care. CONCLUSION After 1 year of implementation, lay navigators still found it difficult to interpret and prioritize complex patient needs in a way that all clinical staff found appropriate. Negotiating these issues has made it difficult to develop the strong relationships with clinical teams that are needed for an integrated approach to patient care. To successfully coordinate patient care, it seems that lay navigation programs should be integrated with clinical teams to provide more seamless patient care.
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来源期刊
Journal of Oncology Practice
Journal of Oncology Practice Nursing-Oncology (nursing)
CiteScore
4.60
自引率
0.00%
发文量
0
期刊介绍: Journal of Oncology Practice (JOP) provides necessary information and insights to keep oncology practice current on changes and challenges inherent in delivering quality oncology care. All content dealing with understanding the provision of care—the mechanics of practice—is the purview of JOP. JOP also addresses an expressed need of practicing physicians to have compressed, expert opinion addressing common clinical problems.
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