Hurria Arti, Lichtman Stuart M, Gardes Jonathan, Li Daneng, Limaye Sewanti, Patil Sujata, Zuckerman Enid, Tew William, Hamlin Paul, Abou-Alfa Ghassan K, Lachs Mark, Kelly Eva
Division of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California 91010, USA.
J Am Geriatr Soc. 2007 Oct;55(10):1604-8. doi: 10.1111/j.1532-5415.2007.01367.x. Epub 2007 Aug 14.
To integrate the principles of geriatric assessment into the care of older patients with cancer in order to identify vulnerable older adults and develop interventions to optimize cancer treatment.
A brief, comprehensive, self-administered questionnaire and intervention algorithm were developed consisting of measures of geriatric assessment that are brief, reliable, validated, and predictive of mortality and morbidity in older patients.
Academic tertiary care cancer center and community-based satellite practice.
Patients aged 65 and older with cancer.
The questionnaire solicits information about the patient's functional status, comorbidity, psychological status, nutritional status, and social support. A scoring algorithm for referral to a multidisciplinary team was developed.
Two hundred forty-five of 250 patients completed the questionnaire (mean age 76, range 65-95). The majority of patients were women (71%), white (95%), married (52%), and retired (90%), with a variety of tumor types and stages. Most patients (78%) completed the questionnaire on their own and reported acceptance of questionnaire length (91%), no difficult questions (94%), no upsetting questions (96%), and no missing questions (89%). The mean time to completion was 15 minutes, with a median of 12.5 (standard deviation 10, range 2-60). Information from this questionnaire helped identify physical and psychological impairments, poor nutrition, lack of social support, and untreated comorbidities. Appropriate referrals to a multidisciplinary team were made.
This brief, comprehensive, self-administered questionnaire is feasible for use in the outpatient oncology setting and helped identify the needs of geriatric oncology patients. Prospective trials are needed to determine the effectiveness of the interventions offered.
将老年评估原则整合到老年癌症患者的护理中，以识别易损老年人群并制定优化癌症治疗的干预措施。
开发了一份简短、全面的自填式问卷和干预算法，其中包括简短、可靠、经过验证且能预测老年患者死亡率和发病率的老年评估指标。
学术性三级护理癌症中心和社区卫星诊所。
65岁及以上的癌症患者。
问卷收集患者的功能状态、合并症、心理状态、营养状况和社会支持方面的信息。制定了转诊至多学科团队的评分算法。
250名患者中有245名完成了问卷（平均年龄76岁，范围65 - 95岁）。大多数患者为女性（71%）、白人（95%）、已婚（52%）且已退休（90%），患有多种肿瘤类型和分期。大多数患者（78%）自行完成问卷，并表示接受问卷长度（91%）、没有难题（94%）、没有令人不安的问题（96%）以及没有遗漏问题（89%）。完成问卷的平均时间为15分钟，中位数为12.5分钟（标准差10，范围2 - 60）。该问卷提供的信息有助于识别身体和心理损伤、营养不良、缺乏社会支持以及未治疗的合并症。已进行了适当的多学科团队转诊。
这份简短、全面的自填式问卷在门诊肿瘤学环境中使用是可行的，并有助于识别老年肿瘤患者的需求。需要进行前瞻性试验以确定所提供干预措施的有效性。
