准备安全癌症治疗(RESET)工具:提高质量和优化及时和安全出院与过渡护理调整头颈癌患者。

IF 1 Q3 OTORHINOLARYNGOLOGY
Małgorzata Wierzbicka, Mariusz Kiszka, Szczepan Barnaś, Mateusz Jeziorny, Bernard Zając, Mariola Dwornikowska-Dąbrowska, Natalia Jędruchniewicz
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引用次数: 0

摘要

& lt; b>介绍:& lt; / b>Ready for Safe Cancer Treatment (RESET)工具是一个结构化的、多模式的项目,旨在优化肿瘤患者的住院治疗并提高围手术期护理的质量。虽然RESET已经发展成为外科肿瘤学的一般框架,但其对头颈癌(HNC)患者的适应性仍然未被探索,尽管他们有独特的生理和心理需求。HNC患者经常面临严重的功能障碍,包括言语、吞咽和呼吸,以及严重的营养缺乏、肌肉减少和心理困扰。本研究探讨了定制RESET工具的可行性,以满足HNC患者的专业化需求。& lt; br> & lt; br> & lt; b>目的:& lt; / b>本研究的目的是评估调整RESET以适应HNC患者特定需求的可行性。研究的重点是确定需要修改的关键领域,以优化围手术期护理,包括康复,营养支持,功能康复和心理护理。流行病学分析、患者需求评估和对核心RESET模块的审查将有助于确定有效的策略,以提高该患者群体的治疗质量和康复结果。最终目标是开发一种更加个性化、基于证据的方法,可以在肿瘤中心实施,以提高HNC患者的治疗效果。& lt; br> & lt; br> & lt; b>方法:& lt; / b>RESET分为四个模块:入院前康复、入院时的高级沟通和需求评估、院内康复优化和出院时的过渡护理计划。本研究包括对波兰两个肿瘤中心HNC患者代表性的横断面流行病学评估,对康复要求的分析,对核心RESET模块的比较评估,以及确定必要的方案改进的差距分析。所提出的方法学方法整合了定量和定性评估,以确保对RESET对HNC患者的适应性进行全面评估。& lt; br> & lt; br> & lt; b>结果:& lt; / b>2023-2024年的数据表明,HNC患者占研究中心肿瘤患者总数的11-25%,显示出明显的人口统计学特征,如年龄分布年轻化和住院时间延长。康复前需求分析强调了结构化营养支持、有针对性的肌肉保存策略和心理干预(包括认知行为治疗)的重要性。此外,核心RESET模块评估强调了加强出院后过渡性护理的必要性,特别是对于需要气管切开术或长期肠内营养支持的患者。差距分析确定了需要加强的关键领域,如全面的肌肉减少症筛查,专门的吞咽困难管理方案,以及多学科的社会心理康复方法。& lt; br> & lt; br> & lt; b>讨论:& lt; / b>HNC患者面临着独特的挑战,需要对RESET框架进行量身定制的修改。与其他肿瘤学队列不同,HNC患者易患功能障碍、高营养缺乏和显著的社会心理负担。在RESET方案中纳入专门的营养策略、康复训练和心理支持可以显著改善治疗效果,减少术后并发症,提高生活质量。尽管采用了结构化的方法,但用于HNC的RESET的主要限制仍然是需要专门的资金和通过前瞻性临床试验进一步验证。& lt; br> & lt; br> & lt; b>结论:& lt; / b>使RESET工具适应HNC患者的需求有可能优化围手术期护理,确保更个性化的循证方法。拟议的修改强调加强营养、身体和心理支持,使RESET与HNC患者面临的具体挑战保持一致。需要进一步的研究和实施研究来验证这一调整框架在改善肿瘤网络医院患者预后方面的有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Ready for Safe Cancer Treatment (RESET) tool: enhancing quality and optimizing timely and safe discharge with transitional care adjustments for Head and Neck Cancer patients.

<b>Introduction:</b> The Ready for Safe Cancer Treatment (RESET) tool is a structured, multimodal program designed to optimize hospitalization and enhance the quality of perioperative care for oncological patients. While RESET has been developed as a general framework for surgical oncology, its adaptation to Head and Neck Cancer (HNC) patients remains unexplored despite their unique physiological and psychological needs. HNC patients frequently face severe functional impairments affecting speech, swallowing, and respiration, as well as heightened nutritional deficiencies, sarcopenia, and psychological distress. This study explores the feasibility of tailoring the RESET tool to meet the specialized requirements of HNC patients. <br><br><b>Aim:</b> The aim of this study is to assess the feasibility of adapting the RESET to the specific needs of HNC patients. The research focuses on identifying key areas requiring modification to optimize perioperative care, including prehabilitation, nutritional support, functional rehabilitation, and psychological care. Epidemiological analysis, patient needs assessment, and a review of the core RESET modules will help determine effective strategies for improving treatment quality and recovery outcomes in this patient group. The ultimate goal is to develop a more personalized, evidence-based approach that could be implemented in oncology centers to enhance treatment outcomes for HNC patients. <br><br><b>Methods:</b> RESET is structured into four modules: pre-admission prehabilitation, advanced communication and need assessment upon admission, intra-hospital recovery optimization, and transitional care planning at discharge. This study includes a cross-sectional epidemiological assessment of HNC patient representation at two oncological centers in Poland, an analysis of prehabilitation requirements, a comparative evaluation of core RESET modules, and a gap analysis identifying necessary protocol enhancements. The proposed methodological approach integrates both quantitative and qualitative assessments to ensure a comprehensive evaluation of RESET's adaptation to HNC patients. <br><br><b>Results:</b> Data from 2023-2024 indicate that HNC patients constitute 11-25% of the total oncological population at the studied centers, demonstrating distinct demographic characteristics such as younger age distribution and extended hospitalization periods. Prehabilitation needs analysis underscores the importance of structured nutritional support, targeted muscle preservation strategies, and psychological interventions, including cognitive behavioral therapy. Additionally, core RESET module evaluations highlight the necessity of enhanced post-discharge transitional care, particularly for patients requiring tracheostomy or prolonged enteral nutrition support. The gap analysis identifies critical areas requiring reinforcement, such as comprehensive sarcopenia screening, specialized dysphagia management protocols, and a multidisciplinary approach to psychosocial rehabilitation. <br><br><b>Discussion:</b> HNC patients present unique challenges that demand tailored modifications to the RESET framework. Unlike other oncological cohorts, HNC patients are predisposed to functional impairments, high nutritional deficits, and significant psychosocial burdens. The inclusion of dedicated nutritional strategies, prehabilitation exercises, and psychological support within the RESET protocol may significantly improve treatment outcomes, reduce postoperative complications, and enhance the quality of life. Despite its structured approach, the main limitation of the RESET adaptation for HNC remains the need for dedicated funding and further validation through prospective clinical trials. <br><br><b>Conclusions:</b> Adapting the RESET tool to the needs of HNC patients has the potential to optimize perioperative care, ensuring a more individualized, evidence-based approach. The proposed modifications emphasize enhanced nutritional, physical, and psychological support, aligning RESET with the specific challenges faced by HNC patients. Further research and implementation studies are required to validate the effectiveness of this adapted framework in improving patient outcomes within oncological network hospitals.

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来源期刊
Polish Journal of Otolaryngology
Polish Journal of Otolaryngology OTORHINOLARYNGOLOGY-
CiteScore
1.30
自引率
16.70%
发文量
15
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