探索低收入和中等收入国家的晚期癌症儿童在诊断时的治疗决策
Marta Salek1, Amy S Porter2, Essy Maradiege3
1St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 721, Memphis, TN, 38105, USA. marta.salek@stjude.org.
概括
在低收入和中等收入国家 (LMICs) 中,晚期癌症儿童的治疗决策是复杂的. 医生的决策受许多因素的影响,对预后不佳的定义有很大的不同.
科学领域:
- 儿科瘤学 儿科瘤学
- 全球健康 全球健康
- 卫生系统研究 卫生系统研究
背景情况:
- 儿童癌症的生存率在全球范围内有所不同,受区域因素的影响.
- 在低收入和中等收入国家 (LMICs) 中,对于晚期/预后不佳的儿科癌症的决策缺乏了解.
研究的目的:
- 描述影响LMIC小儿癌症医生决策的上下文因素.
- 描述医生为提供非治愈治疗和定义"不良预后"的理由.
主要方法:
- 来自LMICs的儿科瘤学家的国际小组参加了重点小组.
- 定性数据经过专题分析和成员检查.
主要成果:
- 来自世卫组织所有全球区域的11名瘤学家参加了会议.
- 影响决策的因素涵盖个人,医院,卫生系统,社区和国家层面.
- 在某些情况下,非治愈性治疗是可以接受的; "预后不佳"的定义是多样化的.
结论:
- 在LMICs中,对儿科癌症的前期治疗决策是可变和具有挑战性的.
- 不一致的"不良预后"定义和代表性不足的因素使决策更加复杂.
- 需要对LMIC患者,家庭和临床医生的观点进行进一步的研究.
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