Summers N, Dawe U, Stewart D A
Alberta Cancer Board, Calgary, Canada.
Bone Marrow Transplant. 2000 Aug;26(4):389-95. doi: 10.1038/sj.bmt.1702534.
Outpatient high-dose chemotherapy and autologous stem cell transplantation (ASCT) has been shown to be feasible in terms of physical morbidity and mortality outcomes, but few data exist on the psychosocial impact of delivering such aggressive therapy in this manner. The purpose of this observational study was to compare effects of inpatient (n = 20) and outpatient (n = 21) modes of care on physical status, psychological well-being, quality of life, personal finances and caregiver burden. Most patients were treated according to their preference for inpatient or outpatient care. Those choosing outpatient care were screened for eligibility according to established criteria for ambulatory management. Measures were taken at baseline, then at days 4-6, 12-16 and 30 post ASCT. Results showed that overall, the psychological, physical, social and financial outcomes of the outpatient ASCT group were comparable, to or better than inpatients. Factors that seem to be important for successful outpatient management are previous experience with cancer treatment, a satisfying quality of life, physical well-being, patient's preference for a particular mode of care and physical proximity to the treatment centre. The study results suggest that outpatient ASCT is an efficient, effective and acceptable form of care for motivated patients and caregivers who have the physical and psychological capability and desire to receive cancer treatment in this manner.
门诊高剂量化疗和自体干细胞移植（ASCT）在身体发病率和死亡率方面已被证明是可行的，但关于以这种激进方式进行治疗所产生的社会心理影响的数据却很少。这项观察性研究的目的是比较住院（n = 20）和门诊（n = 21）两种护理模式对身体状况、心理健康、生活质量、个人财务状况和照顾者负担的影响。大多数患者根据其对住院或门诊护理的偏好接受治疗。根据既定的门诊管理标准对选择门诊护理的患者进行资格筛查。在基线时进行测量，然后在ASCT后的第4 - 6天、12 - 16天和30天进行测量。结果表明，总体而言，门诊ASCT组的心理、身体、社会和财务结果与住院患者相当，甚至优于住院患者。对于成功的门诊管理似乎重要的因素包括既往癌症治疗经验、令人满意的生活质量、身体健康状况、患者对特定护理模式的偏好以及与治疗中心的实际距离。研究结果表明，门诊ASCT对于有身体和心理能力并希望以这种方式接受癌症治疗的积极患者和照顾者来说，是一种高效、有效且可接受的护理形式。
