A qualitative study on blood and marrow transplant recipients' perceptions of health professional roles following BMT and preferences for ongoing care.
Gemma McErlean, Christine Ashley, Anisha Pradhan, Vanessa Yenson, Alana Paterson, Gai Farnham, Fran Owen, Anne-Marie Watson, Peter Presgrave, Ian Kerridge, Elizabeth Halcomb
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引用次数: 0
Abstract
Purpose: Survivors of blood and marrow transplantation (BMT) require life-long follow-up involving both tertiary transplant and primary care services. This paper explores the attitudes and preferences of BMT survivors and their carers regarding the transition from BMT centre care to primary care.
Methods: This qualitative study involved semi-structured interviews with BMT survivors and carers from New South Wales, Australia. Interviews were audio-recorded, transcribed verbatim and thematically analysed.
Results: Twenty-two BMT survivors and six carers were interviewed. Two themes emerged: (1) 'Relationships with health professionals' and (2) 'Challenges of long-term care'. Participants, particularly rural/regional survivors, had diverse views on the availability of community BMT expertise and identified a range of strategies to optimise care for BMT survivors.
Conclusions: These results highlight the importance BMT survivors and carers place on their relationships with, and ongoing access to, specialised BMT teams for long-term care. While some are happy to receive community-based care, concerns exist about the capacity of primary care providers, particularly in rural and regional areas. Improved support, communication and coordination between BMT centres and primary care may help facilitate a person-centred, sustainable shared care model. Provider education, use of telehealth and clear delineation of roles and responsibilities may assist in this transition.
Implications for cancer survivors: As BMT survivors live longer post-treatment, transitions of care and sustainable long-term care models are needed. A shared care approach, integrating specialised BMT teams and local primary care, may optimise outcomes but requires further development to balance accessibility, preferences, and specialised care needs.
目的:血液和骨髓移植(BMT)幸存者需要终生接受三级移植和初级医疗服务的随访。本文探讨了 BMT 幸存者及其护理者对从 BMT 中心护理过渡到初级护理的态度和偏好:这项定性研究对澳大利亚新南威尔士州的 BMT 幸存者和照护者进行了半结构化访谈。对访谈进行了录音、逐字记录和主题分析:共采访了 22 名 BMT 幸存者和 6 名照护者。出现了两个主题:(1)"与医疗专业人员的关系 "和(2)"长期护理的挑战"。参与者(尤其是农村/地区幸存者)对社区 BMT 专业人员的可用性有不同看法,并提出了一系列优化 BMT 幸存者护理的策略:这些结果凸显了 BMT 幸存者和照顾者对他们与 BMT 专业团队的关系以及持续获得 BMT 专业团队的长期护理的重视。虽然有些人乐于接受社区护理,但他们对初级医疗服务提供者的能力表示担忧,尤其是在农村和地区。加强 BMT 中心与基层医疗机构之间的支持、沟通和协调可能有助于促进以人为本、可持续的共同护理模式。对癌症幸存者的影响:随着 BMT 幸存者在治疗后存活时间的延长,需要过渡护理和可持续的长期护理模式。整合 BMT 专业团队和当地初级保健的共同护理方法可优化治疗效果,但需要进一步发展,以平衡可及性、偏好和专业护理需求。
期刊介绍:
Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.