为卵巢癌或子宫内膜癌妇女开发癌症症状综合护理模式

M. G. Christiansen, Mary Jarden, S. Colomer-Lahiguera, M. Eicher, Denise Bryant-Lukosius, M. Mirza, Helle Pappot, Karin Piil
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摘要

患有卵巢癌或子宫内膜癌的妇女在化疗期间会出现多种症状。癌症专科护士具备特定的知识和能力,能够有效监测和管理与治疗相关的毒性反应,并提供自我管理支持。 描述在肿瘤环境中为确诊为卵巢癌或子宫内膜癌的妇女提供综合癌症症状护理模式的构想和发展。 以循证为基础、以患者为中心的参与式流程,用于指导高级实践护理角色的开发、实施和评估--以循证为基础、以患者为中心的参与式高级实践流程(PEPPA)框架指导了这一流程。该框架分为 9 个步骤,前 6 个步骤用于纳入研究证据、吸引主要利益相关者参与并获取其意见。 利益相关者(n = 27)为整个开发过程提供了具体的知识、观点和反馈,并确定了若干需求。经过有条理的讨论,我们开发出了一种新的癌症症状护理模式,其中包括症状管理、电子化患者报告结果以及以护士为主导的会诊形式扩大护理角色等要素。 我们有效地利用了 PEPPA 框架,设计出一种新的癌症症状护理模式,并得到了主要利益相关者的一致认可。 这个由利益相关者参与、以证据为导向的过程可作为模板,供其他希望开发针对特定人群的护理模式以改善癌症症状管理的人使用。 随着癌症护理角色的扩展,新模式有可能提高癌症护理质量和与症状管理相关的健康结果。
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Development of a Comprehensive Model for Cancer Symptom Care for Women With Ovarian or Endometrial Cancer
Women with ovarian or endometrial cancer experience multiple symptoms during chemotherapy. Specialized cancer nurses possess specific knowledge and competencies to effectively monitor and manage treatment-related toxicities and provide self-management support. To describe the conception and development of a comprehensive cancer symptom model of care in an oncological setting for women diagnosed with ovarian or endometrial cancer. The participatory evidence-based, patient-focused process for guiding the development, implementation, and evaluation of advanced practice nursing roles—the participatory, evidence-based, patient-centered process for advanced practice (PEPPA) framework directed the process. The first 6 steps of this 9-step framework were utilized to incorporate research evidence, engage, and obtain the input of key stakeholders. Stakeholders (n = 27) contributed with specific knowledge, perspectives, and feedback to the entire development process, and several needs were identified. Following structured discussions, a new model of cancer symptom care with elements such as symptom management, electronic patient-reported outcomes, and an expanded nursing role in the form of nurse-led consultations was developed. We effectively utilized the PEPPA framework to design a new cancer symptom model of care, that was agreed upon by key stakeholders. This stakeholder-engaged, and evidence-driven process could be used as a template for others wanting to develop a population-specific model of care to improve cancer symptom management. With the expansion of the cancer nursing role, the new model has the potential to improve the quality of cancer care and health outcomes related to symptom management.
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