Consultant Palliative Medicine, Northern Ireland Hospice, Faculty of Life and Health Sciences, University of Ulster, UK.
Palliat Med. 2010 Sep;24(6):623-9. doi: 10.1177/0269216310373163. Epub 2010 Jul 21.
The objective of this study was to compare attitudes of hospice staff towards weight loss and weight assessment in the hospice setting with those of patients with advanced malignancy in the hospital outpatient setting. Two paper-based questionnaires (one for staff and one for patients) were designed. The staff survey was circulated to all hospices in the UK and Ireland, and the patient questionnaire was given to patients attending three oncological care clinics in Belfast, Northern Ireland; Wolverhampton, England; and Auckland, New Zealand. The staff survey was posted to the medical director of each of the 215 hospices in the UK and Ireland. A total of 129 oncology outpatients with a confirmed diagnosis of malignancy and no longer receiving curative oncological interventions took part in the questionnaire. The main outcome measure was descriptive information about hospice weighing practices and attitudes of hospice staff towards weighing patients, and descriptive information was collected about patient attitudes to weighing and weight loss. We found that weighing practices vary across hospices in UK and Ireland. Patients attending the majority of hospices, 96/146 (66%), are rarely weighed. A little over half of hospice staff, 81/146 (56%) considered that weighing could cause patients to be upset. However, 124/129 (96%) of patients with advanced cancer reported that they had never found the experience of being weighed in a healthcare facility upsetting. Some 95/129 (74%) of patients weighed themselves at home and 89% would want to know if their weight was changing. While there is reluctance on the part of many hospice staff to weigh patients, most patients with advanced malignancy in the hospital setting do not report weight measurement to be upsetting.
本研究旨在比较临终关怀工作人员和晚期恶性肿瘤住院患者对临终关怀环境下体重减轻和体重评估的态度。设计了两份基于纸质的问卷（一份供工作人员，一份供患者）。工作人员调查问卷被分发给英国和爱尔兰的所有临终关怀机构，而患者问卷则分发给北爱尔兰贝尔法斯特的三个肿瘤护理诊所、英格兰伍尔弗汉普顿和新西兰奥克兰的患者。工作人员问卷被寄给英国和爱尔兰 215 家临终关怀机构的医疗主任。共有 129 名确诊患有恶性肿瘤且不再接受治愈性肿瘤干预的肿瘤科门诊患者参与了问卷调查。主要的测量指标是关于临终关怀称重实践的描述性信息，以及临终关怀工作人员对给患者称重的态度的描述性信息，并收集了患者对称重和体重减轻的态度的描述性信息。我们发现，英国和爱尔兰的临终关怀机构在称重实践方面存在差异。在大多数临终关怀机构就诊的患者中，96/146（66%）很少被称重。超过一半的临终关怀工作人员，即 81/146（56%）认为称重可能会让患者感到不安。然而，129 名晚期癌症患者中有 124/129（96%）报告说，他们从未发现在医疗机构称重感到不安。大约 95/129（74%）的患者在家中自己称重，89%的患者希望知道自己的体重是否在变化。尽管许多临终关怀工作人员不愿意给患者称重，但大多数在医院环境中患有晚期恶性肿瘤的患者并不报告称重会感到不安。
