基于标准的住院息瘤咨询模型对生命终结结果的影响
Kathryn E Norman1, Mary K Buss2, Kathleen A Lee3
1Department of Internal Medicine (K.E.N.), Section of Medical Oncology, Yale New Haven Hospital, New Haven, Connecticut, USA.
Journal of pain and symptom management
|November 20, 2024
概括
在住院瘤学中实施基于标准的息护理 (PC) 模型改善了早期的PC参与,并减少了终身护理的强度. 这种增强的PC整合导致了接近生命终点的晚期癌症患者的更好的结果.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 早期息治疗 (PC) 整合改善了晚期癌症患者的治疗结果.
- 在全国范围内,住院PC转诊往往超过门诊转诊.
- 一个癌症中心在住院瘤学中实施了基于标准的PC咨询模式,以加强整合.
研究的目的:
- 在住院瘤学中实施新的基于标准的PC咨询模型之前和之后比较死亡结果.
- 评估综合息瘤学服务对终身护理的影响.
主要方法:
- 一个嵌入式的,跨学科的息性瘤咨询团队在瘤楼上成立.
- 对患有晚期/转移性固体癌症或显著症状的患者进行了查.
- 通过使用统计测试,比较了死者在实施前和实施后的结果.
主要成果:
- 实施后,与住院患者 (59%至72%) 和门诊PC (23%至34%) 的参与度增加.
- 观察到较早的首次PC访问 (死亡前76至159天) 和住院长度增加 (22至36天).
- 较少的住院 (71%至57%) 和重症监护室 (ICU) 遭遇 (25%至17%) 在死亡后30天内发生.
结论:
- 在住院瘤学中,基于标准的嵌入式PC咨询模型提高了PC参与度.
- 这种模式与更长的临终关怀和终身护理强度降低有关.
- 这些发现表明,在生命末期,对晚期癌症患者的护理质量有所改善.
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