Index Symptoms and Prognosis Awareness of Patients With Pancreatic Cancer: A Multi-Site Palliative Care Collaborative.

IF 1.3 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES
Journal of Palliative Care Pub Date : 2023-04-01 Epub Date: 2021-03-18 DOI:10.1177/08258597211001596
Alyson M Johnson, Steven Wolf, Mengdi Xuan, Greg Samsa, Arif Kamal, Deborah A Fisher
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引用次数: 1

Abstract

Background: Pancreatic cancer has a poor 5-year survival and carries significant morbidity. Pain is a commonly studied symptom in pancreatic cancer; however, few studies examine the frequency of multiple patient-reported symptoms. Our aim is to ascertain patient-reported symptom burden at initial consultation with a palliative care provider and compare patient prognostic awareness to provider estimation of prognosis.

Methods: Data were extracted from the standardized Quality Data Collection Tool (QDACT). Adults with pancreatic cancer seen by a palliative care provider were included. Descriptive statistics were used to describe demographic features, symptom prevalence and burden, as well as assess patient prognosis awareness defined by congruence or incongruence with provider estimated prognosis.

Results: 285 patients were included in our analysis. The average age was 68 years (SD: 12.4), 87.2% were white, 50% male. The mean number of moderate/severe symptoms was 2.6 (SD: 2) out of 9 symptoms. Tiredness (66.7%), appetite (64.5%) and pain (46.2%) had the highest rates of moderate/severe symptom burden. Patients with a prognosis of 1-6 months had the lowest proportion of congruence with provider estimation (56.5%).

Conclusion: Our study suggests targets to improve patient-centered care of pancreatic cancer. Patients commonly have multiple symptoms that are moderate/severe at time of palliative care referral. While pain has been well-reported, tiredness and decreased appetite are more prevalent at initial visit. This emphasizes the importance of assessing multiple symptoms and working closely with palliative care for early referral. Overall, one third of patient prognosis estimates differed from the provider assessment of prognosis. Our data support the importance of early referral to palliative care to manage symptoms and better prepare patients for end-of-life care.

胰腺癌患者的症状指数和预后意识:多站点姑息治疗合作项目。
背景:胰腺癌的 5 年生存率很低,发病率也很高。疼痛是胰腺癌患者常有的症状,但很少有研究对患者报告的多种症状的频率进行调查。我们的目的是确定病人在与姑息治疗提供者初次会诊时报告的症状负担,并比较病人对预后的认识和提供者对预后的估计:从标准化质量数据收集工具(QDACT)中提取数据。方法:从标准化质量数据收集工具(QDACT)中提取数据,纳入姑息治疗提供者接诊的胰腺癌成人患者。描述性统计用于描述人口统计学特征、症状发生率和负担,以及评估患者对预后的认识,其定义是与提供者估计的预后一致或不一致。平均年龄为 68 岁(标准差:12.4),87.2% 为白人,50% 为男性。在 9 种症状中,中度/重度症状的平均数量为 2.6(标准差:2)。疲倦(66.7%)、食欲不振(64.5%)和疼痛(46.2%)是中度/重度症状负担率最高的症状。预后为 1-6 个月的患者与医疗服务提供者的估计一致的比例最低(56.5%):我们的研究为改善以患者为中心的胰腺癌护理提出了目标。患者在转诊姑息治疗时通常有多种中度/重度症状。虽然疼痛已被广泛报道,但疲倦和食欲下降在初次就诊时更为普遍。这强调了评估多种症状并与姑息治疗密切合作以尽早转诊的重要性。总体而言,三分之一的患者对预后的估计与医护人员对预后的评估不同。我们的数据支持了及早转诊至姑息治疗以控制症状并更好地为患者的临终关怀做好准备的重要性。
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
Journal of Palliative Care
Journal of Palliative Care 医学-卫生保健
CiteScore
3.20
自引率
5.90%
发文量
63
审稿时长
>12 weeks
期刊介绍: The Journal of Palliative Care is a quarterly, peer-reviewed, international and interdisciplinary forum for practical, critical thought on palliative care and palliative medicine. JPC publishes high-quality original research, opinion papers/commentaries, narrative and humanities works, case reports/case series, and reports on international activities and comparative palliative care.
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