?It?s More Difficult??: Clinicians? Experience Providing Palliative Care to Adolescents and Young Adults Diagnosed With Advanced Cancer

被引：29

作者：

Avery, Jonathan ^{[1
]}

Geist, Arielle ^{[1
,2
]}

D'Agostino, Norma Mammone ^{[1
]}

Kawaguchi, Sarah K. ^{[3
]}

Mahtani, Ramona ^{[3
]}

Mazzotta, Paolo ^{[3
,4
]}

Mosher, Pamela J. ^{[1
,4
]}

al-Awamer, Ahmed ^{[1
,4
]}

Kassam, Alisha ^{[4
,5
,6
]}

Zimmermann, Camilla ^{[1
,4
]}

Samadi, Mahsa ^{[1
]}

Tam, Seline ^{[1
,5
]}

Srikanthan, Amirrtha ^{[7
]}

Gupta, Abha ^{[1
,4
]}

机构：

[1] Univ Hlth Network, Toronto, ON, Canada

[2] McMaster Univ, Hamilton, ON, Canada

[3] Sinai Hlth Syst, Toronto, ON, Canada

[4] Univ Toronto, Toronto, ON, Canada

[5] Hosp Sick Children, Toronto, ON, Canada

[6] Southlake Reg Hlth Ctr, Newmarket, ON, Canada

[7] Ottawa Hosp, Ctr Canc, Ottawa, ON, Canada

来源：

JCO ONCOLOGY PRACTICE | 2020年 / 16卷 / 01期

关键词：

PATIENT; FAMILY;

D O I：

10.1200/JOP.19.00313

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

PURPOSE:Adolescents and young adults (AYAs; age 15-39 years) with advanced cancer are a population in whom quality of life is uniquely affected because of their stage of life. However, training focused on palliative care for AYAs is not routinely provided for health care providers (HCPs) in oncology. This study aims to explore the experiences of HCPs involved in introducing and providing palliative care caring for AYAs with advanced cancer and their families to understand the unique challenges HCPs experience.METHODS:Using a qualitative descriptive design, semistructured interviews were conducted with medical and radiation oncologists, palliative care physicians, psychiatrists, and advanced practice nurses involved in caring for AYAs diagnosed with advanced cancer (N = 19). Interviews were transcribed verbatim and analyzed using thematic analysis in combination with constant comparative analysis and theoretical sampling.RESULTS:There were 19 participants, 9 men and 10 women, with a median age of 45 years (range, 24-67 years). Six were palliative care physicians, 5 medical oncologists, 4 nurse practitioners, and 2 each radiation oncologists and psychiatrists. Overall, participants perceived the provision of palliative care for AYAs to be more difficult compared with older adults. Four themes emerged: (1) challenges helping AYAs/families to engage in and accept palliative care, (2) uncertainty regarding how to involve the family, (3) HCP sense of tragedy, and (4) HCP sense of emotional proximity.CONCLUSION:Findings from this study support the development of dedicated training for HCPs involved in palliative care for AYA.

引用

页码：40 / +

页数：10

共 28 条

[1]

[Anonymous], WHO definition of palliative care

[2] Family Members' Retrospective Stories of the Treatment Stage of an Adolescent or Young Adult Who Subsequently Died of Cancer [J].