Page 105 - APPENDIX B: Trials Investigating the Management of Acute Radiation-Induced Skin Reactions Reading Qualitative Research

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WOUND CARE

in the process of being adapted and integrated into the electronic document in a separate

document called the Goals of Care form within the Provincial Health Services Authority. The

form is already in use at Alberta Health Services (Advance care planning goals of care, n.d.).

The Medical Orders Scope of Treatment (MOST) form used by other health authorities in BC is

integrated into ARIA for now, with the approval of the Most Responsible Physician.

Similarly, resources like the Registered Nurses Association of Ontario (RNAO) nursing

Best Practice Guidelines (BPGs) on wound care management such as venous leg ulcers or

pressure ulcers may be integrated into the existing BCCA (2012) document, “Care of radiation

skin reactions” to also include patient preference for when one does not wish to have a dressing

removed during radiotherapy. Kodner and Spreeuwenberg (2002) propose a patient-oriented

definition of ‘integration’ based on their analysis. According to these authors, “Integration is a

coherent set of methods and models on the funding, administrative, organisational, service

delivery and clinical levels designed to create connectivity, alignment and collaboration within

and between the cure and care sectors” (p. 3). The patient-oriented definition essentially

articulates the overarching theme of ‘integration and patient centred care’ with the context of

health care delivery systems. Expert M. McQuestion further suggested:

The voices of patients living with malignant wounds need to be heard to further
understand their experiences. Qualitative research should address areas of importance
to patients (reduction in pain, impression or impact of time to heal, impact of frequent or
daily dressing changes during treatment of dressings left on during treatment, cost to
patient (distress and financial) that may not be captured or valued in quantitative
research. (personal communication, August 30, 2013)

The significance of patient experiences and advantages of using both quantitative and qualitative

approaches in future research, particularly in the context of wound management during

radiotherapy, is gleaned from the expert opinion.