缓和医疗
授权
动机式访谈
护理部
干预(咨询)
医学
家庭医学
面试
政治学
法学
作者
Regina M. Fink,Danielle Kline,Shaunna Siler,Stacy Fischer
出处
期刊:Journal of Hospice & Palliative Nursing
[Ovid Technologies (Wolters Kluwer)]
日期:2020-06-19
卷期号:22 (4): 335-346
被引量:16
标识
DOI:10.1097/njh.0000000000000666
摘要
A lay patient navigator model involving a culturally tailored intervention to improve palliative care outcomes for Hispanics with advanced cancer was tested across 3 urban and 5 rural cancer centers in Colorado. Five home visits were delivered over 3 months to 112 patients assigned to the randomized controlled trial's intervention arm. Grounded in core Hispanic values, visits addressed palliative care domains (advance care planning, pain/symptom management, and hospice utilization). To describe the content of patient navigator visits with patients/family caregivers, research team members analyzed 4 patient navigators' field notes comprising 499 visits to 112 patients. Based on previous work, codes were established a priori to identify ways patient navigators help patients/family caregivers. Key words and comments from field notes were classified into themes using ATLAS.ti and additional codes established. Nine common themes and exemplars describing the lay patient navigator role are described: activation/empowerment, advocacy, awareness, access, building rapport, providing support, exploring barriers, symptom screening, and the patient experience. Patient navigators used advocacy, activation, education, and motivational interviewing to address patient/family concerns and reduce barriers to quality palliative care in urban and rural settings. Adapting and implementing this model across cultures has potential to improve palliative care access to underserved populations.
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