{"title":"在肯尼亚三级医院的门诊癌症患者的提前护理计划的做法：描述性横断面调查。","authors":"Lavender Otom, Peter Oyiro, Elijah Ogola","doi":"10.3332/ecancer.2025.1926","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Advance care planning (ACP) is relevant in the care of cancer patients. Insight into the current practice of ACP can identify high-priority areas to direct interventions aimed at improving the process.</p><p><strong>Objective: </strong>To assess the practice of ACP among ambulatory cancer patients at a Kenyan hospital.</p><p><strong>Methodology: </strong>A descriptive cross-sectional survey was conducted at the ambulatory oncology clinic at a tertiary referral hospital. We recruited 387 study participants through consecutive sampling among heterogenous cancer patients. An interviewer-administered questionnaire was used to collect data, which was analysed by SPSS version 25 and through multivariable logistical regression.</p><p><strong>Results: </strong>Among 387 participants, 78.55% were females. The uptake of advance directives was low; only 27.13% of participants had appointed surrogate decision makers, while 1.5% had living wills. Few had discussed end-of-life wishes with family (28.68%) and doctors (19.63%). Only 27.39% had discussed life expectancy with a doctor. Among those who had not participated in ACP, most were willing to discuss life expectancy (71.9%); discuss end-of-life wishes with family (81.2%) and doctors (85.1%); complete advance directives (68%) and appoint surrogate decision makers (75.9%) in the next 1 month. Doctors were most preferred to initiate ACP discussions. Factors that positively correlated with uptake of advanced directives (ADs) included - ECOG status, discussion with family and with doctors.</p><p><strong>Conclusion: </strong>The uptake of ADs among ambulatory cancer patients was low; additionally, self-reported participation in ACP was low. Our study highlights the need for widespread education initiatives and standardisation of the ACP process.</p><p><strong>Recommendations: </strong>There is a need for further studies and strategies to improve the participation in ACP and hence the quality of life among patients with malignancies in Kenya.</p>","PeriodicalId":11460,"journal":{"name":"ecancermedicalscience","volume":"19 ","pages":"1926"},"PeriodicalIF":1.3000,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12221252/pdf/","citationCount":"0","resultStr":"{\"title\":\"The practice of advance care planning among ambulatory cancer patients at a tertiary hospital in Kenya: descriptive cross-sectional survey.\",\"authors\":\"Lavender Otom, Peter Oyiro, Elijah Ogola\",\"doi\":\"10.3332/ecancer.2025.1926\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Advance care planning (ACP) is relevant in the care of cancer patients. Insight into the current practice of ACP can identify high-priority areas to direct interventions aimed at improving the process.</p><p><strong>Objective: </strong>To assess the practice of ACP among ambulatory cancer patients at a Kenyan hospital.</p><p><strong>Methodology: </strong>A descriptive cross-sectional survey was conducted at the ambulatory oncology clinic at a tertiary referral hospital. We recruited 387 study participants through consecutive sampling among heterogenous cancer patients. An interviewer-administered questionnaire was used to collect data, which was analysed by SPSS version 25 and through multivariable logistical regression.</p><p><strong>Results: </strong>Among 387 participants, 78.55% were females. The uptake of advance directives was low; only 27.13% of participants had appointed surrogate decision makers, while 1.5% had living wills. Few had discussed end-of-life wishes with family (28.68%) and doctors (19.63%). Only 27.39% had discussed life expectancy with a doctor. Among those who had not participated in ACP, most were willing to discuss life expectancy (71.9%); discuss end-of-life wishes with family (81.2%) and doctors (85.1%); complete advance directives (68%) and appoint surrogate decision makers (75.9%) in the next 1 month. Doctors were most preferred to initiate ACP discussions. Factors that positively correlated with uptake of advanced directives (ADs) included - ECOG status, discussion with family and with doctors.</p><p><strong>Conclusion: </strong>The uptake of ADs among ambulatory cancer patients was low; additionally, self-reported participation in ACP was low. Our study highlights the need for widespread education initiatives and standardisation of the ACP process.</p><p><strong>Recommendations: </strong>There is a need for further studies and strategies to improve the participation in ACP and hence the quality of life among patients with malignancies in Kenya.</p>\",\"PeriodicalId\":11460,\"journal\":{\"name\":\"ecancermedicalscience\",\"volume\":\"19 \",\"pages\":\"1926\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-06-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12221252/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ecancermedicalscience\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3332/ecancer.2025.1926\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ecancermedicalscience","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3332/ecancer.2025.1926","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：提前护理计划（Advance care planning， ACP）在癌症患者的护理中具有重要意义。深入了解非加太项目目前的做法可以确定高优先领域，以指导旨在改善该进程的干预措施。目的：评价肯尼亚某医院门诊癌症患者ACP的实施情况。方法：在一家三级转诊医院的肿瘤门诊进行描述性横断面调查。我们在异质性癌症患者中通过连续抽样招募了387名研究参与者。使用访谈者管理的问卷收集数据，并通过SPSS版本25和多变量逻辑回归进行分析。结果：387名参与者中，78.55%为女性。对预先指示的接受程度很低；只有27.13%的参与者指定了代理决策者，1.5%的人有生前遗嘱。很少有人与家人（28.68%）和医生（19.63%）讨论过临终愿望。只有27.39%的人与医生讨论过预期寿命。在没有参加过ACP的受访者中，大多数愿意讨论预期寿命（71.9%）；与家人（81.2%）和医生（85.1%）讨论临终愿望；在接下来的1个月内完成预先指示（68%）并指定代理决策者（75.9%）。医生最倾向于发起ACP讨论。与接受高级指示（ADs）正相关的因素包括ECOG状态、与家人和医生的讨论。结论：非住院癌症患者对ad的摄取较低；此外，自我报告的ACP参与率较低。我们的研究强调了广泛的教育倡议和ACP进程标准化的必要性。建议：有必要进一步研究和制定战略，以提高肯尼亚恶性肿瘤患者对ACP的参与，从而提高他们的生活质量。
The practice of advance care planning among ambulatory cancer patients at a tertiary hospital in Kenya: descriptive cross-sectional survey.
Background: Advance care planning (ACP) is relevant in the care of cancer patients. Insight into the current practice of ACP can identify high-priority areas to direct interventions aimed at improving the process.
Objective: To assess the practice of ACP among ambulatory cancer patients at a Kenyan hospital.
Methodology: A descriptive cross-sectional survey was conducted at the ambulatory oncology clinic at a tertiary referral hospital. We recruited 387 study participants through consecutive sampling among heterogenous cancer patients. An interviewer-administered questionnaire was used to collect data, which was analysed by SPSS version 25 and through multivariable logistical regression.
Results: Among 387 participants, 78.55% were females. The uptake of advance directives was low; only 27.13% of participants had appointed surrogate decision makers, while 1.5% had living wills. Few had discussed end-of-life wishes with family (28.68%) and doctors (19.63%). Only 27.39% had discussed life expectancy with a doctor. Among those who had not participated in ACP, most were willing to discuss life expectancy (71.9%); discuss end-of-life wishes with family (81.2%) and doctors (85.1%); complete advance directives (68%) and appoint surrogate decision makers (75.9%) in the next 1 month. Doctors were most preferred to initiate ACP discussions. Factors that positively correlated with uptake of advanced directives (ADs) included - ECOG status, discussion with family and with doctors.
Conclusion: The uptake of ADs among ambulatory cancer patients was low; additionally, self-reported participation in ACP was low. Our study highlights the need for widespread education initiatives and standardisation of the ACP process.
Recommendations: There is a need for further studies and strategies to improve the participation in ACP and hence the quality of life among patients with malignancies in Kenya.
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