晚期癌症患者的早期息治疗:一个集群随机对照试验
Camilla Zimmermann1, Nadia Swami2, Monika Krzyzanowska3
1Division of Medical Oncology and Haematology, Department of Medicine, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Campbell Family Cancer Research Institute, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Lancet (London, England)
|February 25, 2014
概括
早期的息治疗改善了晚期癌症患者的生活质量和满意度. 虽然在3个月没有显著的效益,但在4个月后观察到的好处,支持其整合.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 生活质量研究 研究 生命质量研究
背景情况:
- 患有晚期癌症的患者经历了生活质量的下降,特别是在临终期.
- 缓解性护理的早期整合旨在缓解这些生活质量下降.
研究的目的:
- 评估早期息护理咨询对晚期癌症患者生活质量的影响.
- 评估对症状严重程度,对护理的满意度和医疗互动问题的影响.
主要方法:
- 集群随机试验涉及24家瘤诊所,比较了息护理团队与标准护理.
- 患有晚期癌症 (ECOG 0-2,预后6-24个月) 的患者每月评估一次,持续4个月.
- 生活质量 (FACIT-Sp, QUAL-E),症状 (ESAS),满意度 (FAMCARE-P16) 和医疗相互作用 (CARES-MIS) 是主要和次要的结局.
主要成果:
- 在4个月后,显著改善有利于早期息护理组在生命结束时的生活质量 (QUAL-E) 和满意度 (FAMCARE-P16) 中.
- 虽然主要终点 (FACIT-Sp在3个月后) 是无意义的,但趋势有利于干预组.
- 症状严重程度 (ESAS) 和医疗相互作用问题 (CARES-MIS) 在3个月后没有显著差异,但在4个月后有所改善.
结论:
- 早期的息护理对晚期癌症患者显示出有前途的好处,提高了整体福祉和护理满意度.
- 尽管主要终点不显著,但该研究支持在疾病发展轨迹的早期整合息护理服务.
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