晚期癌症患者预后讨论的时间:系统性审查
Sharon H Nahm1,2, Shalini Subramaniam1,3, Martin R Stockler1,4
1The NHMRC Clinical Trials Centre, The University of Sydney, Locked Bag 77, Camperdown, Sydney, NSW, 1450, Australia.
概括
与晚期癌症患者讨论预后至关重要. 关键时刻包括诊断,进展和缓解护理之前,需要个性化的方法来更好地理解.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 医学沟通 医学沟通
背景情况:
- 患有晚期癌症的患者往往希望获得预后信息,但讨论往往不足或不存在.
- 讨论晚期癌症的预后的最佳时间是复杂的,并且具体针对患者.
研究的目的:
- 对与晚期癌症患者进行预后讨论的时间进行系统审查和综合研究.
- 确定启动预后对话的关键时间点.
主要方法:
- 在2023年之前对出版物,临床指南和灰色文献进行系统审查.
- 纳入标准侧重于晚期癌症的成年人,并报告了预后讨论的时间点.
主要成果:
- 包括63个参考文献,主要是横截面的队列研究.
- 讨论的共识时间点包括诊断,患者调查,疾病进展,抗癌治疗的结束和息治疗的开始.
- 其他推时间取决于临床判断,例如患者"需要知道"或"准备好"的时候.
结论:
- 预后讨论必须针对晚期癌症患者进行个性化.
- 确定时间点可以为医疗保健提供者指导临床试验设计和沟通培训.
- 改善沟通可以提高患者对预后的理解.
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