Noble S I R, Nelson A, Turner C, Finlay I G
Cardiff University, Cardiff CF10 3XQ.
BMJ. 2006 Mar 11;332(7541):577-80. doi: 10.1136/bmj.38733.616065.802. Epub 2006 Feb 3.
To find out what inpatients with advanced cancer who are receiving palliative care think about the effect of thromoprophylaxis on overall quality of life.
Qualitative study using audiotaping of semistructured interviews.
Regional cancer centre in Wales.
28 inpatients with advanced metastatic cancer receiving palliative care and low molecular weight heparin.
Recurring themes on the effect of thromboprophylaxis on overall quality of life.
Major emerging themes showed that patients knew about the risks of venous thromboembolism and the purpose of treatment with heparin. Media coverage had raised awareness about venous thromboembolism, and many had previous experience of thromboprophylaxis. All found low molecular weight heparin an acceptable intervention, and many said that it improved their quality of life by giving them a feeling of safety and reassurance. Antiembolic stockings were considered uncomfortable and had a negative impact on quality of life. Patients were concerned that because they had advanced disease they might not be eligible for thromboprophylaxis.
Low molecular weight heparin is acceptable to inpatients with advanced cancer receiving palliative care and has a positive impact on overall quality of life. Antiembolic stockings are an unacceptable intervention in this patient group. Guidelines on thromboprophylaxis are urgently needed for palliative care inpatient units and hospices.
了解接受姑息治疗的晚期癌症住院患者对血栓预防措施对总体生活质量影响的看法。
采用半结构化访谈录音的定性研究。
威尔士的地区癌症中心。
28名接受姑息治疗并使用低分子量肝素的晚期转移性癌症住院患者。
关于血栓预防措施对总体生活质量影响的反复出现的主题。
主要出现的主题表明，患者了解静脉血栓栓塞的风险以及肝素治疗的目的。媒体报道提高了对静脉血栓栓塞的认识，许多患者此前有过血栓预防的经历。所有人都认为低分子量肝素是可接受的干预措施，许多人表示，它通过给他们一种安全感和安心感而改善了他们的生活质量。抗栓袜被认为穿着不舒服，对生活质量有负面影响。患者担心，由于他们患有晚期疾病，可能不符合血栓预防的条件。
低分子量肝素对于接受姑息治疗的晚期癌症住院患者是可接受的，并且对总体生活质量有积极影响。抗栓袜在该患者群体中是不可接受的干预措施。姑息治疗住院病房和临终关怀机构迫切需要血栓预防指南。
