在晚期癌症患者中促进与患者指导的预先护理计划:随机临床试验
Yael Schenker1,2,3, Shane C Belin1,2, Tianxiu Wang1
1Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA.
JCO oncology practice
|March 19, 2025
概括
与自主指导工具相比,便利的预先护理计划 (ACP) 显著改善了患者的参与和预先指令的完成. 一些癌症患者可能需要促进者支持,以有效地规划终身护理.
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:
- 提前护理规划 (ACP) 建议以患者为中心的终身护理 (EOL).
- 面向患者的ACP干预措施的最佳方法尚不清楚.
- 干预措施的成本和复杂性各不相同.
研究的目的:
- 为了比较两个面向患者的非洲国家和地区干预措施的有效性.
- 评估在患有晚期固体瘤的患者中,方便的ACP与患者导向的ACP.
主要方法:
- 一个单盲,随机比较的疗效试验.
- 招募了晚期固体瘤的成年患者及其护理人员.
- 参与者被随机分配到辅助的ACP (护士辅导员) 或患者指导的ACP (书面/网络工具).
主要成果:
- 方便的ACP在12周后显示出更高的患者参与度 (4.34对4.08) 和预先指令完成率 (74.8%对60.6%).
- 在与家人或医生谈论EOL愿望的对话中没有发现显著差异.
- 所有的ACP行为在两组中都从基线显著增加.
结论:
- 简化ACP带来了比患者导向材料更大的参与和提前指令完成.
- 一些患有晚期癌症的患者可以从ACP的额外促进者支持中受益.
- 患者导向的ACP是有效的,但可以通过促进加强.
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