Seminars in Oncology Nursing最新文献_第5页

Deconditioning in Hospitalized Patients with Cancer 住院癌症患者的体质下降。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-08-01 DOI: 10.1016/j.soncn.2024.151676

Objectives

Provide an overview of hospital-associated deconditioning in hospitalized patients with cancer, including risk factors and trajectory of deconditioning. Discuss interdisciplinary roles in preventing deconditioning, best practices, and oncology nursing implications.

Methods

A literature search was conducted in PubMed and on Google Scholar using search terms Hospital*, Mobility, Immobility, Deconditioning, Cancer, and Oncology. Peer-reviewed research studies, review articles, and websites of professional organizations were reviewed to provide an overview on mobility concerns in hospitalized patients with cancer.

Results

Thirty-eight references were included in this overview of hospital-associated deconditioning (HAD) in patients with cancer. HAD is a widespread phenomenon with grave consequences. Patients with cancer are particularly vulnerable to HAD due to their cancer diagnosis and treatment effects. Physical activity in hospitalized patients is one of the most important practices to prevent HAD and is achieved through standardized mobility assessment and interdisciplinary collaboration.

Conclusions

Promoting mobility in hospitalized patients with cancer is essential to prevent the complications of HAD.

Implications for Nursing Practice

Nurses are leaders of the interdisciplinary approach to enhance inpatient mobility. As they are most often at the bedside, nurses assess patients’ level of mobility, recognize risk factors for HAD, and implement safe mobility interventions. Nurses experience barriers to promoting mobility including workforce shortages, high workloads, and competing priorities.

目标：概述住院癌症患者中与医院相关的机能减退，包括风险因素和机能减退的轨迹。讨论跨学科在预防失调中的作用、最佳实践以及肿瘤护理的意义：在 PubMed 和 Google Scholar 上进行文献检索，使用的检索词包括医院*、移动性、不移动性、衰竭、癌症和肿瘤学。对同行评议的研究报告、评论文章和专业组织的网站进行了审查，以提供有关住院癌症患者行动不便问题的概述：本综述共收录了 38 篇关于癌症患者住院相关机能减退（HAD）的参考文献。HAD 是一种普遍现象，后果严重。由于癌症诊断和治疗效果，癌症患者尤其容易出现 HAD。住院患者的体育锻炼是预防HAD的最重要措施之一，可通过标准化的活动能力评估和跨学科合作来实现：结论：促进住院癌症患者的行动能力对于预防 HAD 的并发症至关重要：护士是提高住院患者行动能力的跨学科方法的领导者。由于护士通常都在床边，因此她们可以评估患者的行动能力水平，识别导致 HAD 的风险因素，并实施安全的行动能力干预措施。护士在促进行动能力方面会遇到各种障碍，包括劳动力短缺、工作量大以及优先事项相互竞争。

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引用次数: 0

Care Needs, Challenges, and Experiences of Sexual and Gender Minority Cancer Survivors in Taiwan: Findings from a Qualitative Study 台湾少数性与性别癌症幸存者的护理需求、挑战与经验：定性研究结果。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-08-01 DOI: 10.1016/j.soncn.2024.151694

Ya-Ching Wang , Nae-Fang Miao , Mei-Hui You , Frank T.Y. Wang , Chih-Yun Hsu

Objectives

This study aimed to explore the care needs, challenges, and experiences of cancer care among sexual and gender minority (SGM) cancer survivors in Taiwan.

Methods

Semi-structured interviews were conducted face-to-face or telephonically with 30 SGM cancer survivors in Taiwan. Data were analyzed using the socio-ecological model and the constant comparative technique. The study used the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.

Results

The needs, challenges, and experiences of cancer care among SGM cancer survivors were categorized and presented according to the level of the social-ecological model: (1) intrapersonal level: physical and psychological impacts and changes in outlook on life after cancer diagnosis and treatment; (2) interpersonal level: informal social support resources and challenges for developing intimate relationships; (3) community level: formal social support resources and lack of SGM support groups; and (4) societal and policy level: positive and negative experiences with oncology healthcare providers (HCPs), sexual orientation disclosure, and lack of an SGM-friendly environment.

Conclusions

Multilevel care needs and challenges in cancer care among SGM cancer survivors were identified. Oncology HCPs should be aware of and assess SGM cancer survivors’ psychosexual issues and psychological status and provide suitable care resources to individuals. Moreover, training courses on culturally competent cancer care and information on SGM-related health policies (including same-sex marriage) should be provided to oncology HCPs to improve their sensitivity, knowledge, and skills to provide suitable care for SGM cancer survivors.

Implications for Nursing practice

The study findings can be used to design and develop training courses for culturally competent cancer care for oncology HCPs to improve the quality of care and reduce cancer care disparities among SGM cancer patients.

研究目的本研究旨在探讨台湾性与性别少数（SGM）癌症幸存者的护理需求、挑战和癌症护理经验：方法：对 30 名台湾的性与性别少数（SGM）癌症幸存者进行了面对面或电话的半结构化访谈。采用社会生态模型和恒定比较技术对数据进行分析。研究采用了定性研究报告综合标准（COREQ）指南：结果：根据社会生态模型的层次，对上海通用汽车癌症幸存者的癌症护理需求、挑战和经验进行了分类和表述：(1) 人际层次：癌症诊断和治疗后的生理和心理影响以及人生观的改变；(2) 人际层次：非正式的社会支持资源和发展的挑战：非正式的社会支持资源和发展亲密关系的挑战；(3) 社区层面：正式的社会支持资源和缺乏 SGM 支持团体；(4) 社会和政策层面：与肿瘤医疗保健提供者（HCPs）的正面和负面经历、性取向披露和缺乏对 SGM 友好的环境。结论发现了 SGM 癌症幸存者在癌症护理方面的多层次护理需求和挑战。肿瘤科医护人员应了解和评估 SGM 癌症幸存者的性心理问题和心理状况，并为他们提供合适的护理资源。此外，还应为肿瘤科保健人员提供符合文化要求的癌症护理培训课程，以及与 SGM 相关的卫生政策（包括同性婚姻）信息，以提高他们的敏感性、知识和技能，为 SGM 癌症幸存者提供合适的护理：研究结果可用于为肿瘤科保健人员设计和开发具有文化胜任力的癌症护理培训课程，以提高护理质量并减少 SGM 癌症患者的癌症护理差异。

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引用次数: 0

Enhancing Mobility in Oncology: Evidence-Based Practices Across the Care Continuum 增强肿瘤患者的行动能力：基于证据的持续护理实践》。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-08-01 DOI: 10.1016/j.soncn.2024.151677

Nimian Bauder , Leana Cabrera Chien

Objectives

Provide an overview of research-derived insights aimed at elucidating best practices for enhancing mobility in patients with cancer throughout the entirety of the care continuum. Highlighting the value of a multidisciplinary approach involving various healthcare professionals to optimize mobility outcomes for patients with cancer and the benefits of different approaches.

Methods

A literature search was conducted in PubMed/Medline, CINAHL, Scopus, Embase, and on Google Scholar using search terms, mobility, exercise, cancer, nurs*, physical activity, pre-habilitation, rehabilitation, best practices. Systematic reviews, meta-analyses, peer reviewed research studies, exercise, and physical activity recommendations were reviewed to provide a comprehensive overview of strategies aimed at enhancing mobility in patients with cancer.

Results

Twenty-nine references were included in this overview of enhancing mobility in patients with cancer across the care continuum.

Conclusions

Evidence-based strategies prioritize enhancing mobility for patients with cancer, aiming to boost physical functioning and overall quality of life. Healthcare providers should consider each patient's unique needs and limitations when implementing these evidence-based approaches, emphasizing a multidisciplinary approach involving oncologists, surgeons, nurses, physical therapists, occupational therapists, and other professionals to ensure comprehensive and personalized care focused on improving mobility.

Implications for Nursing Practice

Nurses advocate for incorporating exercise into cancer care plans throughout the entire treatment journey, collaborating with healthcare team members to tailor programs to individual patient needs. Working together as an interdisciplinary team, nurses help develop an overall care plan that emphasizes exercise as an important aspect of cancer care, using their expertise to create customized exercise routines to encourage and motivate patients to participate in physical activity.

目标：概述研究得出的见解，旨在阐明在整个护理过程中提高癌症患者行动能力的最佳实践。强调不同医护人员参与的多学科方法对优化癌症患者行动能力结果的价值，以及不同方法的益处：在PubMed/Medline、CINAHL、Scopus、Embase和Google Scholar上进行了文献检索，使用的检索词包括：行动能力、运动、癌症、护理*、体育活动、康复前、康复、最佳实践。对系统综述、荟萃分析、同行评审研究、运动和体育锻炼建议进行了审查，以全面了解旨在增强癌症患者活动能力的策略：结果：本综述共收录了29篇关于在整个护理过程中提高癌症患者活动能力的参考文献：基于证据的策略优先考虑增强癌症患者的行动能力，旨在提高患者的身体机能和整体生活质量。医疗服务提供者在实施这些循证方法时应考虑每位患者的独特需求和局限性，强调肿瘤学家、外科医生、护士、理疗师、职业治疗师和其他专业人员参与的多学科方法，以确保提供以改善行动能力为重点的全面、个性化护理：护士提倡在整个治疗过程中将运动纳入癌症护理计划，并与医疗团队成员合作，根据患者的不同需求制定相应的计划。作为一个跨学科团队，护士可以帮助制定整体护理计划，强调运动是癌症护理的一个重要方面，并利用其专业知识制定个性化的运动程序，鼓励和激励患者参加体育锻炼。

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引用次数: 0

The Power of Movement: Enhancing Mobility in Cancer Care 运动的力量：增强癌症护理中的移动能力。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-08-01 DOI: 10.1016/j.soncn.2024.151691

Jeannine M. Brant , Nimian Bauder

引用次数: 0

Improving Distress Screening for People with Prostate Cancer: Evaluation of an E-Learning Course to Increase Healthcare Professionals’ Knowledge 改善前列腺癌患者的压力筛查：评估电子学习课程以增加医疗保健专业人员的知识。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-08-01 DOI: 10.1016/j.soncn.2024.151656

Objectives

Psychological distress can occur following diagnosis and treatment for prostate cancer, compromising psychosocial wellbeing. Improved recognition and management of distress by healthcare professionals can enhance clinical practice and promote evidence-based prostate cancer care. This paper explores the effectiveness and feasibility of the online Distress Screening for Prostate Cancer course, designed to improve healthcare professionals’ understanding of screening for prostate cancer-related distress. It aims to evaluate whether this e-learning course increases learners’ knowledge of distress screening for prostate cancer.

Methods

Healthcare professionals were invited to enroll in the online course and complete optional evaluation questions. The pretest posttest design identified changes in learners’ knowledge about distress screening for people with prostate cancer, including prevalence, risk factors, assessment and management strategies for distress (n = 149). Learners also rated satisfaction in a cross-sectional survey (n = 116). Most respondents were nurses, including Prostate Cancer Specialist Nurses.

Results

Learners’ knowledge of distress screening was higher after course completion. Improvement between pre- and posttest results was statistically significant for four of ten items, including risk of prostate cancer-related distress, and suicidality, and the purpose of distress screening. Learners reported high satisfaction with course content, structure, engagement, relevance, and approach. They particularly valued the narrative-based approach and interactivity. Small numbers encountered technological problems and some offered suggestions to improve learner feedback.

Conclusions

The course improved healthcare professionals’ knowledge of distress among people affected by prostate cancer. Learners found the e-learning format feasible and acceptable.

Implications for Nursing Practice

Deeper understanding of the psychological implications of diagnosis and treatment of prostate cancer can help healthcare professionals respond to and manage distress among men and their families, and provide supportive care to improve health-related quality of life. Access to an online course can offer effective, feasible education on distress screening.

目的：前列腺癌诊断和治疗后可能会产生心理困扰，影响社会心理健康。提高医护人员对心理困扰的识别和处理能力，可以加强临床实践，促进循证前列腺癌护理。本文探讨了在线前列腺癌困扰筛查课程的有效性和可行性，该课程旨在提高医护人员对前列腺癌相关困扰筛查的认识。方法：邀请医护人员注册在线课程并完成可选的评估问题。通过前测后测设计，确定了学习者对前列腺癌患者窘迫感筛查知识的变化，包括窘迫感的流行率、风险因素、评估和管理策略（n = 149）。学员还在横向调查中对满意度进行了评分（n = 116）。大多数受访者是护士，包括前列腺癌专科护士：结果：完成课程后，学员对窘迫筛查的了解程度更高。在 10 个项目中，有 4 个项目（包括前列腺癌相关窘迫症和自杀的风险以及窘迫症筛查的目的）的前后测试结果差异具有统计学意义。学员对课程内容、结构、参与度、相关性和方法的满意度很高。他们尤其看重基于叙事的方法和互动性。少数学员遇到了技术问题，一些学员提出了改进学员反馈的建议：该课程提高了医护人员对前列腺癌患者痛苦的认识。学员认为电子学习形式可行且可接受：对护理实践的启示：深入了解前列腺癌诊断和治疗的心理影响有助于医护人员应对和处理男性及其家人的痛苦，并提供支持性护理以改善与健康相关的生活质量。在线课程可以提供有效、可行的困扰筛查教育。

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引用次数: 0

Complication Rates of Peripherally Inserted Central Catheters in Oncologic Versus Non-Oncologic Patients 肿瘤患者与非肿瘤患者外周置入中心导管的并发症发生率。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-08-01 DOI: 10.1016/j.soncn.2024.151681

Objectives

Peripherally inserted central catheters are commonly used in cancer patients and provide vascular access for the administration of chemotherapy, antibiotics, or parenteral nutrition. Besides many advantages, they represent a source of possible complications such as catheter related blood stream infection, catheter occlusion, or thrombosis. In this study, the catheter-related complication rate between oncologic and non-oncologic patients was compared.

Methods

This retrospective cohort-study included 411 patients who underwent their first catheter placement at the Vienna General Hospital—Medical University of Vienna from January 2013 to June 2018. Patient demographics and catheter-related parameters were collected and statistically analyzed using a competing risk model.

Results

Mean catheter dwell time was 27.75 days. The overall complication rate was 7.54% (2.72 per 1000 catheter days). Underlying malignant disease (hazard ratio: 0.351, 95% confidence interval [CI]: 0.133-0.929, P = .035) and chemotherapy administration (hazard ratio: 2.837, 95% CI: 1.088-7.394, P = .033) were significantly associated with the occurrence of any kind of complication. Catheter related blood stream infection was observed among 11 (2.68%) patients and again significantly associated with chemotherapy administration (hazard ratio: 4.545, 95% CI: 1.178-17.539; P = .028). Thrombosis was found in 7 (1.70%) patients and occlusion in 13 (3.16%) cases.

Conclusions and implications for nursing practice

Choice of venous access is an interdisciplinary decision with emphasis on patient participation. In oncologic patients, our data suggests that the benefits of peripherally inserted central catheters regarding costs, invasiveness, and accessibility might be outweighed by the higher rate of complications associated with the device. This becomes even more important in a community care setting, where standardized handling procedures and patient education play a pivotal role in device safety.

目的：外周置入中心导管常用于癌症患者，为化疗、抗生素或肠外营养的给药提供血管通路。外周置入中心导管除了具有许多优点外，还可能引起一些并发症，如导管相关血流感染、导管闭塞或血栓形成。本研究比较了肿瘤患者和非肿瘤患者导管相关并发症的发生率：这项回顾性队列研究纳入了 2013 年 1 月至 2018 年 6 月期间在维也纳总医院-维也纳医科大学接受首次导管置入手术的 411 名患者。研究收集了患者的人口统计学特征和导管相关参数，并使用竞争风险模型进行了统计分析：导管平均停留时间为 27.75 天。总并发症发生率为 7.54%（每 1000 个导管天 2.72 例）。潜在恶性疾病（危险比：0.351，95% 置信区间[CI]：0.133-0.929，P = .035）和化疗用药（危险比：2.837，95% 置信区间[CI]：1.088-7.394，P = .033）与各种并发症的发生显著相关。11例（2.68%）患者出现导管相关血流感染，同样与化疗用药密切相关（危险比：4.545，95% CI：1.178-17.539；P = .028）。7例（1.70%）患者出现血栓形成，13例（3.16%）出现闭塞：结论和对护理实践的启示：静脉通路的选择是一个跨学科的决定，重点在于患者的参与。在肿瘤患者中，我们的数据表明，外周置入中心导管在成本、侵入性和可及性方面的优势可能会被其较高的并发症发生率所抵消。在社区护理环境中，这一点变得更加重要，因为在社区护理环境中，标准化处理程序和患者教育对设备安全起着至关重要的作用。

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引用次数: 0

Compassion Fatigue: A Comprehensive Discussion on its Development and Repercussions Among Oncology Nurses 同情疲劳：全面探讨其在肿瘤科护士中的发展和影响。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-08-01 DOI: 10.1016/j.soncn.2024.151655

Objectives

This study aimed to discuss how compassion fatigue (CF) develops and its repercussions on the personal and professional lives of oncology nurses.

Methods

A discursive article, with systematic searches were performed in seven databases to find publications on CF in oncology nurses.

Results

So as to better organize the findings, three categories were developed to present and discuss issues related to CF: (1) Characteristics of CF and its developments: describes the components related to CF and the manifestation of this phenomenon; (2) Repercussions of compassion fatigue: reports on the impact of CF on the personal and professional life of oncology nurses; and (3) Resources for dealing with compassion fatigue: lists interventions, sources of support, professional personal training, qualified nursing care in the face of adversity, and gratitude and recognition.

Conclusion

the factors that trigger or protect CF are multifactorial, with the need for collective and individual interventions as a way of helping oncology nurses to protect themselves, to avoid or manage this phenomenon. CF has a direct clinical impact on the life of the oncology nurse, causing several changes. It also indirectly impacts the patient's life clinically, as it is a phenomenon that has repercussions on the provision of care.

Implications for Nursing Practice

CF affects the personal and professional lives of oncology nurses, so nurses need to seek resources to deal with it. Nursing staff employers and managers can use the evidence from this research to help nurses manage and protect themselves from compassion fatigue.

研究目的本研究旨在讨论同情疲劳（CF）是如何产生的，以及它对肿瘤科护士个人和职业生活的影响：结果：为了更好地组织研究结果，我们在七个数据库中进行了三个方面的研究：为了更好地组织研究结果，我们将研究结果分为三类，分别介绍和讨论与CF相关的问题：（1）CF的特点及其发展：描述了与CF相关的组成部分以及这一现象的表现形式；（2）同情疲劳的后果：报告了CF对肿瘤科护士个人和职业生活的影响；以及（3）应对同情疲劳的资源：列出了干预措施、支持来源、专业个人培训、逆境中的合格护理以及感激和认可。结论：引发或保护同情疲劳的因素是多方面的，需要采取集体和个人干预措施，以此帮助肿瘤科护士保护自己，避免或管理这种现象。CF 对肿瘤科护士的生活有直接的临床影响，会引起一些变化。在临床上，它也会间接影响患者的生活，因为这种现象会对护理工作产生影响：CF 影响着肿瘤科护士的个人生活和职业生活，因此护士需要寻求资源来应对它。护理人员的雇主和管理者可以利用本研究的证据帮助护士管理和保护自己，避免同情疲劳。

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引用次数: 0

Mobility Assessment Instruments 行动能力评估工具。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-08-01 DOI: 10.1016/j.soncn.2024.151660

Kristen L. Fessele , Grigory Syrkin

Objectives

Review commonly used mobility assessment instruments and discuss their use in multidisciplinary research and clinical practice.

Methods

Data sources include peer-reviewed articles sourced in electronic databases (PubMed, CINAHL), government websites, national, and international best practice guidelines to describe frequently used mobility assessment instruments.

Results

Numerous clinician-, observer-, patient-reported, and performance outcome instruments and evidence-based implementation program resources exist, though these vary in their intended purpose and setting. Wearable and ambient sensors provide new opportunities to collect passive, objective physical activity data and observe changes in mobility across settings.

Conclusions

Selection among multiple assessment tools requires consideration of the available evidence for use in the desired population, the outcomes of interest, whether use is feasible for the setting, and the strength of validity and reliability data for the tool.

Implications for Nursing Practice

Nurses, especially in the inpatient setting, are typically in most frequent contact with patients and are well-positioned to assess mobility and ensure that safe, progressive mobility care plans are in place. Development of an organization-wide mobility culture requires a systematic, multidisciplinary approach and long-term commitment.

目的：回顾常用的活动能力评估工具，并讨论其在多学科研究和临床实践中的应用：回顾常用的行动能力评估工具，并讨论其在多学科研究和临床实践中的应用：数据来源包括电子数据库（PubMed、CINAHL）、政府网站、国家和国际最佳实践指南中的同行评议文章，以描述常用的行动能力评估工具：结果：临床医生、观察者、患者报告和表现结果工具以及循证实施计划资源不计其数，但其预期目的和环境各不相同。可穿戴式传感器和环境传感器为收集被动、客观的身体活动数据以及观察不同环境下活动能力的变化提供了新的机会：从多种评估工具中进行选择，需要考虑在目标人群中使用的现有证据、相关结果、在环境中使用是否可行，以及工具的有效性和可靠性数据的强度：护士，尤其是住院环境中的护士，通常与患者的接触最为频繁，因此有能力对患者的行动能力进行评估，并确保制定安全、循序渐进的行动能力护理计划。发展全机构的行动文化需要系统的、多学科的方法和长期的承诺。

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引用次数: 0

Advanced Ovarian Cancer Patients’ Experiences of Surgical Treatment: A Qualitative Analysis 晚期卵巢癌患者的手术治疗经历：定性分析

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-08-01 DOI: 10.1016/j.soncn.2024.151679

Objectives

Recommended treatment for advanced ovarian cancer involves a combination of debulking surgery and chemotherapy. Surgery places a significant burden on a patient's physical, social, sexual, and emotional wellbeing. Existing research exploring the impact of surgery is often limited to questionnaire administration with large gaps between data collection time points, missing key aspects of the perioperative period. Little is known of the experience of ovarian cancer surgical treatment from a patient perspective. This research aims to qualitatively explore advanced ovarian cancer patients’ experience of surgery and identify areas in which quality of life may be impacted.

Methods

Semi-structured telephone or face-to-face interviews were conducted with patients who had undergone combined surgical and chemotherapy treatment. Interviews were audio-recorded and transcribed verbatim. Transcripts were analyzed using an inductive approach to thematic analysis.

Results

Twenty ovarian cancer patients who had undergone debulking surgery participated in interviews lasting between 33 and 68 minutes. Qualitative analysis generated five key themes: (1) care services; (2) experiences of a stoma; (3) preoperative experience; (4) impact of surgery; and (5) coping mechanisms.

Conclusions

Understanding the patient experience of surgical treatment for advanced ovarian cancer can help inform and improve future care. This research explored the ways in which a patient's quality of life is impacted by surgery and highlights areas in which further support may be needed. Knowledge of the patient experience may also aid decision-making for both clinicians and patients when considering different treatment pathways.

Implications for Nursing Practice

Results highlighted two crucial points in the surgical pathway where patients' need for emotional support was significant: during pre-op and recovering from surgery as an inpatient. Nursing staff are key to providing reassurance during this time. Specialized stoma nurses were also essential for supporting patients to adapt to their stomas both physically and psychologically.

目标：晚期卵巢癌的推荐治疗方法包括切除手术和化疗。手术对患者的身体、社交、性和情感健康造成了极大的负担。探索手术影响的现有研究往往局限于问卷调查，数据收集时间点之间存在较大差距，从而遗漏了围手术期的关键环节。从患者角度对卵巢癌手术治疗的体验知之甚少。本研究旨在从定性角度探讨晚期卵巢癌患者的手术经历，并找出可能影响生活质量的方面：对接受过手术和化疗联合治疗的患者进行了半结构化电话或面对面访谈。对访谈进行了录音和逐字记录。采用归纳式主题分析方法对笔录进行分析：20 名接受过切除手术的卵巢癌患者参加了访谈，访谈时间从 33 分钟到 68 分钟不等。定性分析产生了五个关键主题：(1) 护理服务；(2) 造口体验；(3) 术前体验；(4) 手术影响；(5) 应对机制：结论：了解晚期卵巢癌患者的手术治疗经历有助于为今后的护理工作提供信息并加以改进。这项研究探讨了手术对患者生活质量的影响，并强调了可能需要进一步支持的领域。了解患者的经历也有助于临床医生和患者在考虑不同治疗途径时做出决策：研究结果表明，在手术路径的两个关键点上，患者对情感支持的需求非常大：术前和手术后的住院恢复期。在此期间，护理人员是提供安抚的关键。造口专科护士对于帮助患者在生理和心理上适应造口也至关重要。

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引用次数: 0

Using Mobility Tools within Multidimensional Assessments to Increase Prognostic Awareness and Assist in Shared Decision-Making to Enhance Goal Concordant Care 在多维评估中使用移动工具，提高预后意识并协助共同决策，以加强目标一致的护理。

IF 2.3 4区医学 Q1 NURSING

Seminars in Oncology Nursing

Pub Date : 2024-08-01 DOI: 10.1016/j.soncn.2024.151675

Objectives

The purpose of this practice example from one clinical center is to illustrate the use of interdisciplinary mobility, nutrition, and quality-of-life tools to guide prognostication, which can facilitate discussion on further treatment and goals of care.

Methods

Peer-reviewed scientific publications, expert opinions, and a case study are used to illustrate the advantages of using interdisciplinary assessment tools to assist in prognostication, culminating in shared decision-making.

Results

This overview includes tools identified for use by interdisciplinary teams to identify high-risk patients appropriate for timely discussions regarding goals of care to maximize the probability that people receive care aligned with their goals and values that are informed by prognostic concordance.

Conclusions

Tools assessing mobility, functional status, nutrition, and quality of life can assist the interdisciplinary team in providing whole-person care and in forecasting mortality, thus giving the team valid and reliable information to present to patients and families in the shared decision-making process. Further research is needed to synthesize findings from these tools and share information amongst team members in a cohesive and reliable manner.

Implications for Nursing Practice

Nurses spend more time at the bedside than any other discipline. Improved knowledge of tools to forecast patients at elevated risk for mortality will empower collaboration with other disciplines to improve prognostic concordance and enhance shared decision-making culminating in optimal patient-centered care.

目标：本实践案例来自一个临床中心，目的是说明如何使用跨学科的移动、营养和生活质量工具来指导预后，从而促进对进一步治疗和护理目标的讨论：方法：利用同行评审的科学出版物、专家意见和病例研究来说明使用跨学科评估工具来协助预后判断的优势，最终实现共同决策：本综述包括跨学科团队使用的工具，以确定适合及时讨论护理目标的高风险患者，从而最大限度地提高患者接受符合其目标和价值观的护理的可能性，而这些目标和价值观是以预后一致性为基础的：评估行动能力、功能状态、营养和生活质量的工具可以帮助跨学科团队提供全人护理和预测死亡率，从而为团队提供有效可靠的信息，在共同决策过程中提供给患者和家属。需要进一步开展研究，以综合这些工具的研究结果，并在团队成员之间以团结、可靠的方式共享信息：对护理实践的启示：与其他学科相比，护士在床边工作的时间更长。提高对预测高死亡风险患者的工具的认识，将增强与其他学科的合作，以改善预后一致性并加强共同决策，最终实现以患者为中心的最佳护理。

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