Ledeboer Quirine C P, Van der Velden Lilly-Ann, De Boer Maarten F, Feenstra Louw, Pruyn Jean F A
Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC, Rotterdam, The Netherlands.
Acta Otolaryngol. 2006 Sep;126(9):975-80. doi: 10.1080/00016480600606764.
The findings of this study justify the goals of the Expert Centre such as the improvement of somatic and psychosocial care and consultation.
A recent review showed that little attention is paid to palliative care for head and neck patients. The Erasmus MC has initiated an Expert Centre of Palliative Care Head and Neck Oncology with special interest in patient care, consultation and research. In this study the experience of general practitioners (GPs) in their care of palliative head and neck cancer patients before the start of the Expert Centre is assessed. The aim of the study was to find possible gaps in care and communication and to use GP's ideas to improve the centre's functioning.
Fifty-five GPs with a patient in their practice who died from head and neck cancer between January 2003 and July 2004 after being treated in the Erasmus MC were included. The GPs were asked to fill out a questionnaire regarding their experience in the care of palliative head and neck cancer patients, the communication between first- and third-line care providers and the work of both the GP and the specialist involved.
The response rate was 75%. The palliative stage lasted approximately 4 months. The GPs felt that symptom control was generally not sufficient. Also improvements were necessary in psychosocial care and in the communication between first- and third-line care providers. They also experienced gaps in their knowledge of specific head and neck oncologic palliative care.
本研究结果证明了专家中心的目标是合理的,例如改善躯体和心理社会护理及会诊。
最近的一项综述表明,对头颈部患者的姑息治疗关注甚少。伊拉斯姆斯医学中心已设立了一个头颈部肿瘤姑息治疗专家中心,特别关注患者护理、会诊和研究。在本研究中,评估了全科医生(GP)在专家中心成立之前对头颈部姑息性癌症患者的护理经验。该研究的目的是找出护理和沟通中可能存在的差距,并利用全科医生的想法来改善该中心的运作。
纳入了55名全科医生,他们的一名患者于2003年1月至2004年7月在伊拉斯姆斯医学中心接受治疗后死于头颈部癌症。要求全科医生填写一份问卷,内容涉及他们对头颈部姑息性癌症患者的护理经验、一线和三线护理提供者之间的沟通以及全科医生和相关专科医生的工作。
回复率为75%。姑息阶段持续约4个月。全科医生认为症状控制总体上不够充分。心理社会护理以及一线和三线护理提供者之间的沟通也需要改进。他们在特定头颈部肿瘤姑息治疗知识方面也存在差距。