Improvement of X-ray therapeutic care in oncology dispensaries in the aspect of a value-oriented approach

Abstract

Relevance. The study is devoted to the study of organizational and methodological, interdisciplinary and value-oriented problems of the use of X-ray therapeutic technology in the provision of oncological care. Purpose of the study. To develop and scientifically substantiate organizational and methodological approaches and recommendations for improving RT care in oncology dispensaries. Materials and methods. The sociological method (questionnaires, in-depth interviews), data extraction from medical records, mathematical and statistical methods were used. Results and discussion. Three main models of organizing RT care are substantiated and differentiated. The potential for increasing the availability of RT care is realized through improving operational efficiency (duration of an RT session = 12.1 min.), the efficiency of equipment use (throughput - 36 patients per shift), optimization of the schedule and operating mode. Changes in clinical guidelines have led to an increase in the average bed-day from 12 to 24 days, which requires taking this factor into account when planning the work of the radiation therapy department and using prognostic mathematical models. Taking into account patient-associated factors improves the individual patient experience. Younger age (r=-0.398, p=0.009) and female gender (r=-0.475, p=0.001) are factors associated with higher emotional distress about appearance, which requires consideration when choosing therapy. Older patients were less involved in choosing a treatment method (r=-0.633, p=0.001). The use of a patient-oriented communication algorithm allows achieving satisfactory involvement (≥3 points, out of 4) in 67% of patients. Conclusion. For the first time, organizational and methodological approaches and ways of improving RT care have been developed in accordance with modern goals, objectives, values ​​and trends in healthcare in general and oncological care in particular.

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