"The biggest challenge is there's never a routine": a qualitative study of the time burdens of cancer care at home.

IF 2.8 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Supportive Care in Cancer Pub Date : 2025-01-27 DOI:10.1007/s00520-024-09132-8
Preethiya Sekar, Whitney V Johnson, Manju George, Allison Breininger, Helen M Parsons, Rachel I Vogel, Anne H Blaes, Arjun Gupta
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Abstract

Purpose: As cancer care is increasingly delivered in the home, more tasks and responsibilities fall on patients and their informal care partners. These time costs can present significant mental, physical, and financial burdens, and are undercounted in current measures of time toxicity that only consider care received in formal healthcare settings.

Methods: Semi-structured qualitative interviews were conducted with patients with gastrointestinal cancer and informal care partners at a single tertiary cancer center between March and October 2023. Interviews explored cancer care tasks conducted when home, associated time burdens, how these time burdens compared to facility-based care, and whether home-based care should be included in objective measures of time toxicity. Two coders transcribed interviews and analyzed data using a grounded theory approach.

Results: A single interviewer conducted semi-structured interviews with 15 patients and 18 care partners, and identified five major themes: (1) unexpected home-based care activities are time burdensome; (2) other burdens interact with and impact time burdens; (3) time burdens evolve over the disease course and differentially impact patients and care partners; (4) several factors influence the choice of home-based versus in-facility care; and (5) home-based care is generally perceived as less time-burdensome than in-facility care. Overall, 12 of 33 (36%) participants recommended including days with home-based care in the current contact days measure of time toxicity.

Conclusion: In addition to characterizing time burdens associated with home-based cancer care, this study builds on existing literature to explore if and how to incorporate days with home-based care into the contact days measure.

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"最大的挑战是从来没有例行公事":一项关于在家护理癌症的时间负担的定性研究。
目的:随着癌症治疗越来越多地在家中进行,患者及其非正式护理伙伴承担了更多的任务和责任。这些时间成本可能会造成巨大的精神、身体和经济负担,而目前的时间毒性测量方法只考虑了在正规医疗机构接受的护理,因此未充分考虑这些时间成本:方法:2023 年 3 月至 10 月期间,我们在一家三级癌症中心对胃肠道癌症患者和非正式护理伙伴进行了半结构化定性访谈。访谈探讨了在家进行的癌症护理任务、相关的时间负担、这些时间负担与设施护理的比较,以及是否应将在家护理纳入时间毒性的客观测量中。两名编码员对访谈进行了转录,并采用基础理论方法对数据进行了分析:一名访谈者对 15 名患者和 18 名护理伙伴进行了半结构化访谈,确定了五大主题:(1)意想不到的居家护理活动会造成时间负担;(2)其他负担与时间负担相互作用并产生影响;(3)时间负担随病程变化,并对患者和护理伙伴产生不同影响;(4)多种因素会影响居家护理与住院护理的选择;以及(5)人们普遍认为居家护理的时间负担低于住院护理。总体而言,33 位参与者中有 12 位(36%)建议将居家护理天数纳入当前的时间毒性接触天数测量中:除了描述与居家癌症护理相关的时间负担外,本研究还以现有文献为基础,探讨是否以及如何将居家护理天数纳入接触天数衡量标准。
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来源期刊
Supportive Care in Cancer
Supportive Care in Cancer 医学-康复医学
CiteScore
5.70
自引率
9.70%
发文量
751
审稿时长
3 months
期刊介绍: Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.
期刊最新文献
Methodologies and characteristics of studies investigating the cost of the palliative phase of cancer: a systematic review. The citizen perspective on challenges and rehabilitation needs among individuals treated for head and neck cancer: a qualitative study. "The biggest challenge is there's never a routine": a qualitative study of the time burdens of cancer care at home. Musculoskeletal symptoms associated with aromatase inhibitors in the treatment of early breast cancer: A scoping review of risk factors and outcomes. Sleep quality in lung cancer and specifically non-small-cell lung cancer: a rapid review.
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