在晚期癌症中,患者报告的护理目标与治疗意图之间的不一致
Manan P Shah1, Neil S Wenger2, John Glaspy1
1Division of Hematology/Oncology, University of California, Los Angeles, California, USA.
Cancer
|August 25, 2025
概括
癌症晚期患者通常会得到延长生命的护理, 癌症患者比其他严重疾病患者更常见.
科学领域:
- 癌症学
- 缓和护理
- 医疗服务研究
背景情况:
- 符合目标的护理确保治疗符合患者的偏好.
- 了解护理目标与治疗意图之间的一致性至关重要,尤其是在严重疾病中.
- 之前的研究还没有完全详细地比较其他严重疾病的晚期癌症患者.
研究的目的:
- 将患者报告的治疗目标和治疗意图与其他严重疾病之间的一致性进行比较.
- 在这些患者群体中描述延长寿命与以舒适为中心的护理偏好和接收的普遍性.
- 根据晚期癌症患者的护理一致性分析死亡率.
主要方法:
- 在预先治疗计划试验中对成年患者的基线调查数据进行横截面分析.
- 患者表示他们更喜欢延长生命的护理,而不是以舒适为中心的护理.
- 晚期癌症患者与其他严重疾病患者之间的一致率的比较;根据一致性分层的死亡率分析.
主要成果:
- 晚期癌症患者 (n=231) 与其他严重疾病患者相比,对以舒适为重点的治疗 (49%) 和24个月死亡率 (16%) 的偏好相似 (分别为48%和13%).
- 在那些更喜欢以舒适为重点的治疗者中,晚期癌症患者 (n=113) 报告接受不一致的延长寿命治疗 (37%) 的可能性明显高于其他疾病患者 (n=413; 19%, p < .001).
- 在偏好舒适性治疗的晚期癌症患者中,在接受不一致的延长寿命治疗 (24%) 和一致的舒适性治疗 (15%, p = .31) 之间,没有观察到24个月死亡率的显著差异.
结论:
- 很大一部分晚期癌症患者报告不一致的护理, 接受延长寿命的治疗,
- 与其他严重疾病患者相比,这种异常在晚期癌症患者中更为普遍.
- 这项研究突出了与晚期癌症患者目标相协调的差距.
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