希望和疾病期望:一项针对晚期癌症患者的横截面研究
Martin Loučka1,2, Andrew D Althouse3, Robert M Arnold4,5
1Third Faculty of Medicine, Charles University, Prague, Czech Republic.
Palliative medicine
|December 13, 2023
概括
临床医生可以通过澄清疾病预期来支持晚期癌症患者的希望. 现实的期望不一定会减少希望,使得生命末期的沟通和护理结果更好.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 心理社会瘤学
背景情况:
- 害怕希望减弱可能会阻止临床医生向晚期癌症患者传递严重的消息.
- 不切实际的患者期望使决策和终身护理复杂化.
- 了解希望和疾病期望之间的联系对于有效的患者沟通至关重要.
研究的目的:
- 在晚期癌症患者中调查现实的疾病预期与希望水平之间的关联.
- 为了确定现实的期望是否与这一群体的希望减少有关.
主要方法:
- 从息护理集群随机试验的基线数据的横截面二次分析CONNECT.
- 使用赫斯·霍普指数评估的希望.
- 疾病预期通过了解治疗目标,预期寿命和绝症确认来评估疾病预期.
- 多变量回归调整为人口和临床因素.
主要成果:
- 分析了672名晚期癌症患者的数据.
- 现实的预期在10%至46%之间,具体取决于具体的问题.
- 在患者之间没有发现希望水平的显著差异,患者的疾病预期更多或不那么现实.
- 平均希望得分为39分 (IQR = 36-43).
结论:
- 希望可以与现实的和不现实的疾病期望并存.
- 临床医生应该专注于澄清患者的期望,同时支持他们的希望.
- 改进的沟通策略可以增强晚期癌症患者的终身护理.
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