Porzio Giampiero, Ricevuto Enrico, Aielli Federica, Verna Lucilla, Cannita Katia, Pollice Rocco, Aloisi Paolo, Porto Claudio, Marchetti Paolo, Ficorella Corrado
Medical Oncology Department, Supportive Care Task Force, University of L'Aquila, L'Aquila, Italy.
Support Care Cancer. 2005 Jun;13(6):351-5. doi: 10.1007/s00520-004-0772-5. Epub 2005 Feb 23.
The Supportive Care Task Force (SCTF) was established within the Medical Oncology Department at the University of L'Aquila in May 2002. The missions of the SCTF were to allow systematic evaluation and treatment of symptoms, to warrant continuity of care in all phases of disease and to provide medical oncology residents with training in the treatment of symptoms. A medical oncologist, two senior residents in medical oncology and a registered nurse comprised the SCTF. A psychiatrist, two neurologists, a dietician, and two physiotherapists served as consultants or on a part-time basis. Four beds in two-bedded rooms inside the Medical Oncology Department were reserved to SCTF. A close integration with the physicians of the Medical Oncology Department was realised. The only criterion to admission was the presence of uncontrolled symptoms. Patients were evaluated and monitored with the visual analogue scale for pain and with the Edmonton Symptom Assessment Scale (ESAS). The Palliative Prognostic Score (PaP Score) was employed to assess the prognosis. Non-clinical needs were evaluated with the Need Evaluation Questionnaire (NEQ). Protocols for the treatment of common symptoms were available in written form for consultation by physicians, residents and nurses. From 1 May 2002 to 31 May 2004, we observed 208 patients: 111 women and 97 men. The median age was 64.7 (range 28-90) years. Fifty-four patients (25.9%) were admitted more than once, for a total of 285 admissions. One hundred ninety-nine admissions (69.5%) were for supportive care while 86 admissions (30.5%) were for supportive care and active treatment. The most frequent symptoms were asthenia and anorexia. We registered excellent results regarding the treatment of pain, nausea and dyspnea while psychological symptoms, anorexia and asthenia proved more difficult to treat. Two hundred twenty patients were discharged: 142 (49.8%) home; 76 (26.7%) to the Home Care Service and two (0.7%) to others units of the hospital. Sixty-five (22.8%) died in our unit.
2002年5月，阿奎拉大学医学肿瘤学系成立了支持治疗特别工作组（SCTF）。SCTF的任务是对症状进行系统评估和治疗，确保在疾病的各个阶段提供持续护理，并为医学肿瘤学住院医师提供症状治疗方面的培训。SCTF由一名医学肿瘤学家、两名医学肿瘤学高级住院医师和一名注册护士组成。一名精神科医生、两名神经科医生、一名营养师和两名物理治疗师担任顾问或兼职工作。医学肿瘤学系内两间双人病房中的四张床位预留给SCTF使用。实现了与医学肿瘤学系医生的紧密合作。入院的唯一标准是存在未得到控制的症状。使用视觉模拟疼痛量表和埃德蒙顿症状评估量表（ESAS）对患者进行评估和监测。采用姑息预后评分（PaP评分）来评估预后。使用需求评估问卷（NEQ）对非临床需求进行评估。针对常见症状的治疗方案以书面形式提供，供医生、住院医师和护士参考。2002年5月1日至2004年5月31日，我们观察了208例患者：111名女性和97名男性。中位年龄为64.7岁（范围28 - 90岁）。54例患者（25.9%）多次入院，共计285次入院。199次入院（69.5%）是为了接受支持治疗，而86次入院（30.5%）是为了接受支持治疗和积极治疗。最常见的症状是乏力和厌食。我们在疼痛、恶心和呼吸困难的治疗方面取得了优异的效果，而心理症状、厌食和乏力则较难治疗。220例患者出院：142例（49.8%）回家；76例（26.7%）转至家庭护理服务机构，2例（0.7%）转至医院其他科室。65例（22.8%）在我们科室死亡。
