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胃癌患者自报告的护理体验及护理结局,随访时间中位数为诊断后27个月。

Self-reported experience and outcomes of care among stomach cancer patients at a median follow-up time of 27 months from diagnosis.

作者信息

Kim Sung, Bae Jae-Moon, Kim Young-Woo, Ryu Keun Won, Lee Jun Ho, Noh Jae-Hyung, Sohn Tae-Sung, Hong Seong-Kweon, Lee Myung Kyung, Park Sang Min, Yun Young Ho

机构信息

Department of Surgery, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea.

出版信息

Support Care Cancer. 2008 Jul;16(7):831-9. doi: 10.1007/s00520-007-0340-x. Epub 2007 Oct 2.

Abstract

GOALS OF WORK

We aimed to identify clinical experiences associated with outcomes of care among stomach cancer patients.

MATERIALS AND METHODS

Four hundred thirty-two patients who had a diagnosis of stage I-III stomach cancer from 2001 through 2002 from two hospitals in South Korea responded to a survey questionnaire including sociodemographic and clinical data, information about care experiences, satisfaction with care, and quality of life (QOL).

MAIN RESULTS

Involvement in decision making [adjusted odds ratio (aOR) = 1.81; 95% confidence interval (CI), 1.13 to 2.89] and reflection of patients' opinions in treatment decisions (aOR = 2.54; 95% CI, 1.65 to 3.93) were associated with decision satisfaction. The factors associated with willingness to choose the same treatment over again were involvement in decision making (aOR = 2.37; 95% CI, 1.53 to 3.68) and no treatment toxicity (aOR = 0.50; 95% CI, 0.29 to 0.87). Involvement in decision making, reflection of patients' opinions in treatment decisions, and treatment toxicity were associated with some functioning subscales of QOL (p < 0.05). Regular follow-up, however, was associated with poor social functioning.

CONCLUSIONS

Quality improvement efforts for stomach cancer patients should focus not only on the quality of primary tumor therapy but also on how patients experience their care, such as patient-centered decision making, experience of treatment toxicity, and regular follow-up.

摘要

工作目标

我们旨在确定与胃癌患者护理结局相关的临床经历。

材料与方法

2001年至2002年期间,来自韩国两家医院的432例诊断为I - III期胃癌的患者对一份调查问卷做出了回应,该问卷包括社会人口统计学和临床数据、护理经历信息、护理满意度以及生活质量(QOL)。

主要结果

参与决策(调整优势比[aOR]=1.81;95%置信区间[CI],1.13至2.89)以及患者意见在治疗决策中的体现(aOR = 2.54;95% CI,1.65至3.93)与决策满意度相关。与愿意再次选择相同治疗相关的因素包括参与决策(aOR = 2.37;95% CI,1.53至3.68)和无治疗毒性(aOR = 0.50;95% CI,0.29至0.87)。参与决策、患者意见在治疗决策中的体现以及治疗毒性与生活质量的一些功能子量表相关(p < 0.05)。然而,定期随访与较差的社会功能相关。

结论

针对胃癌患者的质量改进工作不仅应关注原发性肿瘤治疗的质量,还应关注患者对其护理的体验,如以患者为中心的决策、治疗毒性体验和定期随访。

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