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What matters to patients? A mixed method study of the importance and consideration of oncology patient demands

机译:对患者有什么事?一种混合方法研究肿瘤患者需求的重要性和考虑

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摘要

Abstract Background A patient-centred approach is increasingly the mandate for healthcare delivery, especially with the growing emergence of chronic conditions. A relevant but often overlooked obstacle to delivering person-centred care is the identification and consideration of all demands based on individual experience, not only disease-based requirements. Mindful of this approach, there is a need to explore how patient demands are expressed and considered in healthcare delivery systems. This study aims to: (i) understand how different types of demands expressed by patients are taken into account in the current delivery systems operated by Health Care Organisations (HCOs); (ii) explore the often overlooked content of specific non-clinical demands (i.e. demands related to interactions between disease treatments and everyday life). Method We adopted a mixed method in two cancer centres, representing exemplary cases of organisational transformation: (i) circulation of a questionnaire to assess the importance that breast cancer patients attach to every clinical (C) and non-clinical (NC) demand identified in an exploratory inquiry, and the extent to which each demand has been taken into account based on individual experiences; (ii) a qualitative analysis based on semi-structured interviews exploring the content of specific NC demands. Results Further to the way in which the questionnaires were answered (573 answers/680 questionnaires printed) and the semi-structured interviews (36) with cancer patients, results show that NC demands are deemed by patients to be almost as important as C demands (C = 6.53/7 VS. NC = 6.13), but are perceived to be considered to a lesser extent in terms of pathway management (NC = 4.02 VS C = 5.65), with a significant variation depending on the type of non-clinical demands expressed. Five types of NC demands can be identified: demands relating to daily life, alternative medicine, structure of the treatment pathway, administrative and logistic assistance and demands relating to new technologies. Conclusions This study shows that HCOs should be able to consider non-clinical demands in addition to those referring to clinical needs. These demands require revision of the healthcare professionals’ mandate and transition from a supply-orientated system towards a demand-driven approach throughout the care pathway. Other sectors have developed hospitality management, mass customisation and personalisation to scale up approaches that could serve as inspiring examples.
机译:摘要背景患者中心的方法越来越多地是医疗保健交付的任务,特别是慢性病的出现不断增长。提供人心的护理的相关但经常被忽视的障碍是根据个体经验的所有需求的识别和审议,不仅是基于疾病的要求。注意这种方法,需要探索如何在医疗保健交付系统中表达和考虑患者需求。本研究旨在:(i)了解患者表达的不同类型的需求在由医疗保健组织(HCOS)运营的当前送货系统中被考虑在考虑到; (ii)探讨经常被忽视的特定非临床需求内容(即与疾病治疗与日常生活之间的相互作用有关)。方法采用两种癌症中心的混合方法,代表了组织转型的示例性案例:(i)调查问卷的流通,以评估乳腺癌患者附着在每种临床(C)和非临床(NC)需求中确定的重要性探索性调查,以及根据个体经验所考虑的程度; (ii)基于半结构化访谈的定性分析,探索具体数控需求的内容。结果进一步向问卷解答(573答案/ 680调查问卷)和半结构化访谈(36)患有癌症患者,结果表明,患者认为NC要求几乎与C要求一样重要( C = 6.53 / 7与NC = 6.13),但在途径管理方面被认为是较小程度的程度(NC = 4.02 Vs C = 5.65),具体变化取决于非临床需求的类型表达。可以确定五种类型的NC要求:与日常生活,替代医学,治疗途径结构有关的要求,行政和后勤援助和与新技术有关的要求。结论本研究表明,除了指参考临床需求的情况外,HCO还应该能够考虑非临床需求。这些要求要求修订医疗保健专业人员的任务和从提供的供向制度转变为整个护理途径的需求驱动的方法。其他部门制定了酒店管理,大规模定制和个性化,以扩大可作为鼓舞人心的例子的方法。

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