Gupta Vivek, Kumar Sandeep, Shukla Abhishek, Kumar Shailendra, Kumar Surender
Department of General Surgery, King George's Medical University, Lucknow 226003, Uttar Pradesh, India.
Natl Med J India. 2007 Mar-Apr;20(2):74-7.
The geriatric population in India is increasing, and so is the prevalence of cancer. We aimed to study the knowledge, attitude and practices of end-of-life care issues of terminally ill geriatric cancer patients in our region.
A pilot cross-sectional qualitative study using case studies, focus group discussions on providers and recipients of palliative care, an open-ended, interviewer administered questionnaire on specialist doctors and practitioners (50), geriatric cancer patients (20) and healthy family members of patients (30), was done in Lucknow, the capital of Uttar Pradesh, India.
Only 14 physicians (28%) could enumerate more than 3 important technical elements of end-of-life care. Two physicians (4%) utilized palliative care services but none had received training themselves. The explanations and counselling provided by physicians were mostly inadequate, incomplete and did not fully satisfy the patients and their relatives. Of the cancer patients, 19 (95%) desired to use special services but were unaware of such facilities. There was only one charitable organization for needy geriatric cancer patients in Lucknow. No specific health scheme existed in the programme of the Government of Uttar Pradesh.
The knowledge and practices of physicians and specialists were not up to the expectations and requirements of terminally ill cancer patients. Curriculum-based learning or organized teaching of end-of-life care issues was non-existent. Western countries have well-organized subspecialty facilities for end-of-life needs; such facilities are lacking in India. Capacity building for the care of terminally ill geriatric cancer patients is urgently required in north India.
印度老年人口在增加，癌症患病率也在上升。我们旨在研究本地区晚期老年癌症患者临终关怀问题的知识、态度和实践。
在印度北方邦首府勒克瑙开展了一项试点横断面定性研究，采用案例研究、针对姑息治疗提供者和接受者的焦点小组讨论，以及由访谈者管理的开放式问卷，对象包括专科医生和从业者（50人）、老年癌症患者（20人）以及患者的健康家庭成员（30人）。
只有14名医生（28%）能够列举出临终关怀超过3项重要技术要素。两名医生（4%）使用了姑息治疗服务，但他们自己都未接受过培训。医生提供的解释和咨询大多不充分、不完整，不能完全满足患者及其亲属的需求。在癌症患者中，19人（95%）希望使用特殊服务，但并不知晓此类设施。勒克瑙只有一个面向贫困老年癌症患者的慈善组织。北方邦政府的项目中没有专门的健康计划。
医生和专家的知识与实践未达到晚期癌症患者的期望和需求。不存在基于课程的临终关怀问题学习或有组织的教学。西方国家有组织完善的针对临终需求的亚专业设施；印度则缺乏此类设施。印度北部迫切需要加强对晚期老年癌症患者护理的能力建设。
