接受姑息治疗的晚期癌症门诊患者临终关怀意愿的稳定性和性别特征。前瞻性观察研究。

IF 2 4区 医学 Q3 ONCOLOGY
Oncology Research and Treatment Pub Date : 2024-01-01 Epub Date: 2024-03-01 DOI:10.1159/000538112
Thomas Golombek, Nora Hegewald, Astrid Schnabel, Hansjakob Fries, Florian Lordick
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引用次数: 0

摘要

简介在晚期癌症患者的治疗过程中,早期整合姑息关怀和预先护理计划(ACP)发挥着越来越重要的作用。预先医疗指示(AD)和患者对生命末期(EoL)护理的偏好是 ACP 的重要方面。在门诊环境中,这些文件和临终关怀意愿的普遍性没有得到很好的调查,纵向过程中的变化也不甚了解:方法:从 2020 年 6 月到 2022 年 8 月,对 67 名接受癌症姑息治疗的晚期实体瘤门诊患者进行了关于 ACP 主题的纵向访谈。从该数据库中收集了AD的患病率、医疗保健代理、EoL护理意愿以及就这些问题进行咨询的需求。此外,还对患者的 EoL 护理意愿的稳定性进行了研究:51名患者(76.1%)报告患有注意力缺失症,41名患者(61.2%)报告有医疗代理。19名(37.3%)有注意力缺失症的患者和 11 名(68.7%)无注意力缺失症的患者表示希望获得心理咨询。在大约 6 个月的时间里,所报告的 EoL 护理愿望保持稳定。然而,随着时间的推移,在不同的起居护理偏好中,个体内部也发生了变化。男性对复苏和透析的愿望明显高于女性(复苏:21 位男性中有 15 位(71.4%)希望进行透析;透析:21 位男性中有 15 位(71.4%)希望进行复苏):21名男性中的15人(71.4%)与22名女性中的9人(40.9%)相比,几率比[OR]为3.611,95%置信区间[CI]为1.01至12.89,P=0.048;透析:23名男性中的16人(69.6%)与25名女性中的9人(36.0%)相比,OR为4.063,95%置信区间[CI]为1.22至13.58,P=0.023):我们的研究结果表明,在我们的研究队列中,AD 和医疗保健代理的比例相当高。观察到的EoL请求的稳定性鼓励对接受姑息治疗的门诊患者进行AD和医疗代理的结构化查询。我们的数据表明,在这种情况下应进一步调查性别特征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Stability of End-of-Life Care Wishes and Gender-Specific Characteristics of Outpatients with Advanced Cancer under Palliative Therapy: A Prospective Observational Study.

Introduction: Early integration of palliative care and advance care planning (ACP) play an increasingly important role in the treatment of patients with advanced cancer. Advance directives (ADs) and patients' preferences regarding end-of-life (EoL) care are important aspects of ACP. In the outpatient setting, the prevalence of those documents and EoL care wishes is not well investigated, and changes in the longitudinal course are poorly understood.

Methods: From June 2020 to August 2022, 67 outpatients with advanced solid tumors undergoing palliative cancer therapy were interviewed on the topic of ACP in a longitudinal course. From this database, the prevalence of ADs, healthcare proxy, EoL care wishes, and the need for counseling regarding these issues were collected. In addition, EoL care wishes were examined for their stability.

Results: Fifty-one patients (76.1%) reported having ADs, and 41 patients (61.2%) reported having a healthcare proxy. Nineteen patients (37.3%) with ADs and 11 patients (68.7%) without ADs indicated a wish for counseling. Reported EoL care wishes remained stable over a period of approximately 6 months. Nevertheless, intraindividual changes occurred over time within the different EoL care preferences. The desire for resuscitation and dialysis were significantly higher in men than in women (resuscitation: 15 of 21 men [71.4%] versus 9 of 22 women [40.9%], odds ratio [OR] 3.611, 95% confidence interval [CI], 1.01-12.89, p = 0.048; dialysis: 16 of the 23 men [69.6%] versus 9 of the 25 women [36.0%], OR: 4.063, 95% CI: 1.22-13.58, p = 0.023).

Conclusion: Our results show a reasonably high percentage of ADs and healthcare proxies in our study cohort. The observed stability of EoL requests encourages the implementation of structured queries for ADs and healthcare proxy for outpatients undergoing palliative treatment. Our data suggest that gender-specific characteristics should be further investigated in this context.

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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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