晚期癌症患者如何构思预后:一种现象学定性调查
Laura C Polacek1,2, Rebecca M Saracino1, Leah E Walsh1,2
1Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Palliative medicine
|May 26, 2023
概括
患有晚期癌症的患者使用医学数据,生存预期和生命影响来确定预后. 了解患者的价值观和应对方式对于有效的生命终结沟通至关重要.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 定性研究是指质量研究.
背景情况:
- 对于晚期癌症患者来说,准确的预后理解至关重要,但其概念化和测量缺乏共识.
- 现有的研究往往侧重于临床医生定义的方面,忽视了患者对预后的看法.
研究的目的:
- 探索晚期癌症患者如何概念化他们的预后.
- 研究患者对预后信息的价值及其对生活前景的影响.
主要方法:
- 采用了一种现象学方法.
- 对29名英语和西班牙语发达癌症患者进行了半结构面试.
主要成果:
- 患者通过医学数据,生存/生活质量,生活事件,不确定性和医生影响来概念化预后.
- 应对策略包括维持正常状态,利用知识,重构信息和调整决策.
结论:
- 临床医生必须在临终讨论期间评估患者的偏好,价值观和应对方式.
- 培训应强调非语言线索的重要性,并影响预后披露的管理.
相关概念视频
Cancer Survival Analysis
402
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
402
Tumor Progression
6.4K
Tumor progression is a phenomenon where the pre-formed tumor acquires successive mutations to become clinically more aggressive and malignant. In the 1950s, Foulds first described the stepwise progression of cancer cells through successive stages.
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
Colon cancer is one of the best-documented examples of tumor progression. Early mutation in the APC gene in colon cells causes a small growth on the colon wall called a polyp. With time, this polyp grows into a benign, pre-cancerous tumor. Further...
6.4K
Kubler Ross's Stages of Dying
140
Elisabeth Kübler-Ross significantly advanced psychology's understanding of the process of dying with her influential book, On Death and Dying (1969). She focused on studying terminally ill individuals and outlined five stages commonly experienced when coping with death: denial, anger, bargaining, depression, and acceptance.
In denial, individuals reject the reality of their condition, often thinking, "This isn't true; I feel fine," as a way to protect themselves from...
In denial, individuals reject the reality of their condition, often thinking, "This isn't true; I feel fine," as a way to protect themselves from...
140
Nursing Ethical Principles II
1.0K
Ethical principles are essential in guiding nurses to fulfill their responsibilities, focusing on the quality of nursing care and decision-making. These principles, including autonomy, beneficence, non-maleficence, justice, and fidelity, shape the ethical framework within healthcare settings.
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
1.0K
Kaplan-Meier Approach
200
The Kaplan-Meier estimator is a non-parametric method used to estimate the survival function from time-to-event data. In medical research, it is frequently employed to measure the proportion of patients surviving for a certain period after treatment. This estimator is fundamental in analyzing time-to-event data, making it indispensable in clinical trials, epidemiological studies, and reliability engineering. By estimating survival probabilities, researchers can evaluate treatment effectiveness,...
200
Continuing Care
1.5K
Continuing care describes the variety of health, personal, and social services provided over a prolonged period. The need for continuing care is increasing because people are living longer. Many people do not have families or others to care for them. Continuing care is mainly for patients who are disabled, functionally dependent, or suffering from a terminal disease. It is available within institutional settings or in homes. Examples include nursing centers or facilities, assisted living,...
1.5K


