摘要
目的:从肿瘤患者自身需求出发,分析肿瘤患者整合康复服务需求及其影响因素,为服务提供方提供参考.方法:于2024 年7-8 月,采用访谈法对上海市市级医院、区级医院、社区卫生服务中心、患者及家属、学生志愿者、社区工作者、医务社工等群体进行访谈,了解医护、患者、社会三方视角下肿瘤患者康复需求及其影响因素,确定调查问卷;采用方便抽样方法选取上海市某肿瘤医院各科室就诊的 485 名肿瘤患者及家属开展问卷调查,包括肿瘤患者基本信息、康复服务需求、康复服务需求的影响因素 3 个部分.结果:肿瘤患者对心理支持与调适(390/485,80.41%)、营养与饮食指导(388/485,80.00%)、身体功能康复(371/485,76.49%)的服务需求最高;医疗机构提供的专业服务十分重要,但家庭成员、社区资源的作用仍不容忽视.影响肿瘤患者康复服务需求的重要因素分别为医保政策和费用支持、康复项目的可行性和便利性、知识水平和了解程度.访谈结果显示,多视角下患者均存在生理、心理及社会康复需求,尽管患者的康复需求旺盛,但实际服务利用不足,整合康复服务提供及其体系建设仍存在困境.结论:肿瘤患者的整合康复服务需求旺盛,需从肿瘤患者实际需求出发,提供多学科、整合式、跨专业、个性化康复服务;构建肿瘤患者康复服务分层网络体系,发挥医疗机构、社区、家庭的协同赋能;破除肿瘤患者康复服务壁垒,提升服务可及性.
Abstract
Objective:To analyze integrated rehabilitation service demands and influencing factors of cancer patients from the perspective of their demands,so as to provide references for service providers.Methods:From July to August 2024,the interview method was used to interview groups such as Shanghai municipal hospitals,district hospitals,community health centers,patients and their families,student volunteers,community workers and medical social workers to understand the rehabilitation demands of cancer patients and their influencing factors under the tripartite perspectives of healthcare,patients and society,and the question-naire was determined.The questionnaire survey was conducted among 485 cancer patients and their families in a cancer center in Shanghai using convenience sampling,including three parts,namely,the basic information of cancer patients,the demands for re-habilitation services and the determinants of demands for rehabilitation.Results:Cancer patients have the highest demands for serv-ices of psychological support and adjustment(390/485,80.41%),nutritional and dietary guidance(388/485,80.00%),and physical function rehabilitation(371/485,76.49%).Professional services provided by medical institutions are important,but the roles played by family members and community resources should not be ignored.The important factors affecting cancer patients'will-ingness to receive rehabilitation services are medical insurance policy and cost support,feasibility and convenience of rehabilitation programs and knowledge and understanding levels,respectively.Interview results show that physical,psychological and social reha-bilitation demands are existent in patients under multiple perspectives.Despite the strong demands for integrated rehabilitation serv-ices among patients,there are still insufficient utilization and dilemmas in the provision of these services and the system develop-ment.Conclusion:The demands for integrated rehabilitation services among cancer patients are strong.It is recommended to pro-vide integrated,multidisciplinary and personalized rehabilitation services from the actual demands of cancer patients,build a tiered network system of rehabilitation services for cancer patients to give full play to the synergistic empowerment of medical institutions,communities and families,and break down the barriers of rehabilitation services for cancer patients to improve the accessibility.
维普
万方数据