Sử dụng dịch vụ chăm sóc giảm nhẹ trong ung thư và huyết học: tổng quan hệ thống về các rào cản và yếu tố thuận lợi từ quan điểm của các chuyên gia y tế, bệnh nhân trưởng thành và gia đình họ
Tóm tắt
Mặc dù có tiềm năng cao để cải thiện chất lượng cuộc sống của bệnh nhân và gia đình, dịch vụ chăm sóc giảm nhẹ đối mặt với những rào cản đáng kể trong việc sử dụng chúng. Tại các quốc gia có hệ thống y tế tài nguyên cao, những rào cản phi tài chính và phi cấu trúc trong dịch vụ chăm sóc giảm nhẹ đặc biệt nổi bật. Đây là những rào cản về nhận thức - những rào cản về kiến thức và giao tiếp - trong việc sử dụng chăm sóc giảm nhẹ. Đến nay, chưa có đánh giá hệ thống nào dành cho sự quan tâm xứng đáng đối với các rào cản và yếu tố thuận lợi để sử dụng dịch vụ chăm sóc giảm nhẹ.
Nghiên cứu này nhằm tổng hợp kiến thức về các rào cản và yếu tố thuận lợi liên quan đến việc sử dụng dịch vụ chăm sóc giảm nhẹ trong ung thư và huyết học từ trải nghiệm của các chuyên gia y tế, bệnh nhân và gia đình họ.
Một đánh giá hệ thống đã được thực hiện. PubMed, PsycINFO, Hiệp hội quốc tế về Chăm sóc giảm nhẹ và Hỗ trợ/Cơ sở dữ liệu thống kê y học và hỗ trợ sức khỏe (IAHPC/CINAHL), và hoàn thành Truyền thông & Truyền thông đại chúng (CMMC) đã được tìm kiếm một cách hệ thống cho các khái niệm cốt lõi chính: chăm sóc giảm nhẹ, rào cản, yếu tố thuận lợi, quan điểm, góc nhìn và các thuật ngữ và đồng nghĩa liên quan. Sau khi sàng lọc các tiêu đề, tóm tắt và toàn văn, 52 nghiên cứu đã được đưa vào phân tích chủ đề định tính.
Bốn chủ đề đã được xác định: nhận thức về chăm sóc giảm nhẹ, hợp tác và giao tiếp trong các bối cảnh liên quan đến chăm sóc giảm nhẹ, thái độ và niềm tin đối với chăm sóc giảm nhẹ, và cảm xúc liên quan đến các con đường bệnh tật. Các kết quả cho thấy rằng các rào cản và yếu tố thuận lợi về nhận thức tham gia vào các khía cạnh giáo dục, xã hội, cảm xúc và văn hóa của quá trình cung cấp và sử dụng dịch vụ chăm sóc giảm nhẹ. Đặc biệt, những rào cản và yếu tố thuận lợi này tồn tại ở cả cấp độ chuyên gia y tế (ví dụ: một rào cản là thiếu hiểu biết về tính áp dụng của chăm sóc giảm nhẹ, và một yếu tố thuận lợi là sự hiện diện chiến lược của đội ngũ chăm sóc giảm nhẹ tại các tầng bệnh và sự kiện toàn bệnh viện) và ở cấp độ bệnh nhân và gia đình (ví dụ: một rào cản là có những hiểu lầm về chăm sóc giảm nhẹ, và một yếu tố thuận lợi là sự cởi mở của bệnh nhân về nhu cầu của chính họ).
Để tối ưu hóa việc sử dụng dịch vụ chăm sóc giảm nhẹ, cần nâng cao nhận thức về chăm sóc giảm nhẹ, cũng như kỹ năng giao tiếp và quản lý cảm xúc của các chuyên gia y tế. Thêm vào đó, cần khuyến khích một sự thay đổi văn hóa liên quan đến thái độ và niềm tin đối với chăm sóc giảm nhẹ.
Từ khóa
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