癌症患者的早期和晚期代码状态文档由专门的支持性护理团队管理
Lisa Choucroun1,2, Yves Libert3,4, Alexia Anastasoglou5
1Institut Jules Bordet, Secteur Psycho-Oncologie, ULB, Rue Meylemeersch 90, 1070, Brussels, Belgium.
概括
支持性护理团队有助于编码状态 (CS) 文档,但它经常被记录迟. 需要进一步的策略来鼓励早期讨论和记录患者护理偏好.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 在瘤学瘤学.
- 医学伦理 医学伦理
背景情况:
- 支持性护理团队专注于终身护理 (EOL).
- 早期代码状态 (CS) 文档可以改善患者和家庭的准备.
- 临床医生可以主动促进对EOL护理决定的理解和接受.
研究的目的:
- 为了比较早期与晚期的CS文档的发生率,类型和预测因素.
- 评估专门的支持性护理团队在CS文档中的作用.
- 确定与及时进行CS讨论相关的因素.
主要方法:
- 在一个综合性癌症中心对134名已故患者的回顾性研究.
- 从医疗记录中提取CS文档数据.
- 早期 (>死亡前30天) 和晚期 (死亡前30天) CS文档预测者的比较.
主要成果:
- 85%的患者有记录的CS;36%的病例是早期记录的.
- 早期的CS文档更有可能是做-不-复苏 (DNR),而晚期的文档更倾向于最佳支持性护理 (BSC).
- 早期CS文档的预测因素包括已婚/伴侣,妇科/乳腺或肺癌诊断,以及在支持性护理开始时最小的功能限制.
结论:
- 代码状态文档是频繁的,但往往发生迟,即使与支持性护理团队.
- 专门的支持性护理团队有助于整体高的CS文档化率.
- 需要额外的临床策略来促进早期的CS文档和讨论.
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