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开发一种术后护理决策辅助工具;评估医护人员和患者的偏好。

Developing an aftercare decision aid; assessing health professionals' and patients' preferences.

作者信息

Klaassen Linda, Dirksen Carmen, Boersma Liesbeth, Hoving Ciska

机构信息

Department of Health Promotion/CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.

Department of KEMTA/CAPHRI Care and Public Health Research Institute, Maastricht University Medical Centre, Maastricht, the Netherlands.

出版信息

Eur J Cancer Care (Engl). 2018 Mar;27(2):e12730. doi: 10.1111/ecc.12730. Epub 2017 Jul 20.

Abstract

Personalising aftercare for curatively treated breast cancer patients is expected to improve patient satisfaction with care. A patient decision aid can support women in making decisions about their aftercare trajectory, but is currently not available. The aim of this study was to assess the needs of patients and health professionals with regard to an aftercare decision aid to systematically develop such a decision aid. Focus groups with patients and individual interviews with health professionals were digitally recorded and coded using the Framework analysis. Although most patients felt few aftercare options were available to them, health professionals reported to provide various options on the patients' request. Patients reported difficulty in expressing their need for options to their health professional. Although most patients were unfamiliar with decision aids, the majority preferred a paper-based patient decision aid, while most health professionals preferred an online tool. The practical implications for the intended patient decision aid are: that a digital tool with paper-based element should be developed, the patient decision aid should facilitate both rational and intuitive processes and should provide insight in patients' preferences concerning aftercare to discuss these explicitly.

摘要

为接受根治性治疗的乳腺癌患者提供个性化的术后护理有望提高患者对护理的满意度。患者决策辅助工具可以帮助女性就其术后护理轨迹做出决策,但目前尚无此类工具。本研究的目的是评估患者和医疗专业人员对术后护理决策辅助工具的需求,以便系统地开发这样一种决策辅助工具。对患者焦点小组和医疗专业人员的个人访谈进行了数字记录,并使用框架分析法进行编码。尽管大多数患者觉得自己可选择的术后护理方案很少,但医疗专业人员报告称会根据患者要求提供各种选择。患者表示难以向医疗专业人员表达自己对更多选择的需求。尽管大多数患者不熟悉决策辅助工具,但大多数患者更喜欢纸质版的患者决策辅助工具,而大多数医疗专业人员更喜欢在线工具。对预期的患者决策辅助工具的实际启示是:应开发一种带有纸质元素的数字工具,患者决策辅助工具应促进理性和直观的过程,并应提供患者对术后护理偏好的见解以便进行明确讨论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/302c/5900871/e01f1134fc69/ECC-27-na-g001.jpg

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