Palliative Care for the Management of Patients with Allogeneic Hematopoietic Stem-Cell Transplantation: A Cross-Sectional Survey in Comprehensive Cancer Centers.

IF 1.6 4区 医学 Q3 ONCOLOGY
Anne Pralong, Marco Herling, Udo Holtick, Berenike Schoerger, Alinda Reimer, Sukhvir Kaur, Christof Scheid, Michael Hallek, Jithmi Weliwitage, Martin Hellmich, Raymond Voltz, Steffen T Simon
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Abstract

Introduction: Specialist palliative care (SPC) is rarely integrated into the management of patients with an allogeneic hematopoietic stem-cell transplantation, despite considerable symptom burden and mortality. We aimed to assess hematologists' and nurses' views on SPC integration.

Methods: Multi-center cross-sectional survey with exploratory character. We asked when to best integrate SPC, with three vignettes of patients with good (90% chance of cure/10% risk of death), "fifty-fifty," or poor (10%/90%) prognosis, and assessed preferences regarding integration models and support. We calculated descriptive statistics and associations with chi2/Fisher's exact tests and non-parametric tests.

Results: There were 80 respondents (56% females; mean age: 36.2 years, SD = 7.7; 47 physicians and 33 nurses; 42 in transplant setting, 28 in general oncology/hematology, 9 in intensive care unit, 1 unknown; mean experience: 6 years, SD = 0-25). Participants, regardless of profession, highly agreed to integrate SPC for patients with poor prognosis (Yes = 96%), but a majority would not do so for good prognosis patients (No = 63%). In "fifty-fifty" prognosis, there was no agreement among physicians, whereas nurses would mostly integrate SPC. The preferred integration model for patients with poor or "fifty-fifty" prognosis was a co-management for specific patients' needs. Participants primarily wanted palliative care specialists to support them in addressing life threat with patients.

Conclusion: This study highlights the need to develop accurate integration criteria of SPC in the transplant trajectory, taking multi-professional perspectives into account.

同种异体造血干细胞移植患者的姑息治疗管理:综合癌症中心的横断面调查。
专科姑息治疗(SPC)很少整合到异体造血干细胞移植患者的管理中,尽管有相当大的症状负担和死亡率。我们旨在评估血液学家和护士对SPC整合的看法。方法:采用探索性多中心横断面调查。我们询问何时将SPC与预后良好(90%的治愈机会/10%的死亡风险)、“对半”或预后差(10%/90%)的患者进行最佳整合,并评估了整合模式和支持方面的偏好。我们计算了描述性统计,并与Chi2/Fisher精确检验和非参数检验进行了关联。结果:调查对象80人(56%为女性),平均年龄36.2岁,SD = 7.7;医生47人,护士33人;移植42人,普通肿瘤科/血液科28人,ICU 9人,未知1人;平均工作经验6年,SD = 0-25。无论职业如何,参与者都高度同意对预后差的患者整合SPC(赞成= 96%),但大多数患者不会对预后良好的患者这样做(反对= 63%)。在“对半”的预后中,医生之间没有一致意见,而护士大多会整合SPC。对于预后较差或“一半一半”的患者,首选的整合模式是针对特定患者的需求进行共同管理。参与者主要希望姑息治疗专家支持他们解决患者的生命威胁。结论:本研究强调需要制定准确的SPC在移植过程中的整合标准,并考虑到多专业的观点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
0.00%
发文量
84
期刊介绍: With the first issue in 2014, the journal ''Onkologie'' has changed its title to ''Oncology Research and Treatment''. By this change, publisher and editor set the scene for the further development of this interdisciplinary journal. The English title makes it clear that the articles are published in English – a logical step for the journal, which is listed in all relevant international databases. For excellent manuscripts, a ''Fast Track'' was introduced: The review is carried out within 2 weeks; after acceptance the papers are published online within 14 days and immediately released as ''Editor’s Choice'' to provide the authors with maximum visibility of their results. Interesting case reports are published in the section ''Novel Insights from Clinical Practice'' which clearly highlights the scientific advances which the report presents.
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