Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Palliative Care Centre of Expertise, VU University Medical Centre, Amsterdam.
Fam Pract. 2011 Dec;28(6):689-95. doi: 10.1093/fampra/cmr035. Epub 2011 Jun 15.
In the Netherlands, GPs performed euthanasia or physician-assisted suicide (EAS) in ∼1 of 10 end-of-life cancer patients in their care. Of all explicit requests for EAS directed at GPs, ∼44% resulted in EAS. However, the suffering of patients who do and do not request EAS has never been studied. An important barrier for such research is the low prevalence of end-of-life cancer patients per practice (on average two/year). We studied whether it is possible to recruit end-of-life cancer patients, following-up for requests for EAS (if any), in an interview study in general practice, whether selection occurred and which were the threats and opportunities to recruitment. Our target was to recruit at least 50 patients.
Characteristics of all eligible patients were monitored.
One in every three eligible patients were recruited by 44 GPs in a 3-year inclusion period, resulting in 64 patients in the interview study with follow-up until death. The prevalence of explicit requests for EAS was higher (27%; P = 0.026) in the interview sample, and the presence of a depressed mood according to the GP was lower (5%; P = 0.013) than in the sample with eligible but not participating patients.
Recruitment of slightly more than the minimal target number of end-of-life cancer patients in this study in general practice was realized. Monitoring of all eligible patients permitted to evaluate the selection which occurred. Recruitment through GPs who were direct professional colleagues of one of the researchers was a positive recruitment factor.
在荷兰，全科医生为约 10%的临终癌症患者实施了安乐死或协助自杀（EAS）。所有直接向全科医生提出的 EAS 请求中，约有 44%导致了 EAS。然而，从未研究过接受和不接受 EAS 请求的患者的痛苦。这种研究的一个重要障碍是每个实践中临终癌症患者的患病率较低（平均每年两名）。我们研究了在普通实践中是否可以通过采访研究招募临终癌症患者，以跟进他们的 EAS 请求（如果有），是否存在选择，以及招募的威胁和机会是什么。我们的目标是在 3 年的纳入期内招募至少 50 名患者。
监测所有符合条件的患者的特征。
在 3 年的纳入期内，44 名全科医生招募了每三名符合条件的患者中的一名，最终有 64 名患者参加了采访研究，并随访至死亡。采访样本中明确要求 EAS 的比例更高（27%；P=0.026），而根据全科医生的评估，情绪低落的患者比例更低（5%；P=0.013）。
在这项普通实践中的研究中，略多于临终癌症患者的最小目标人数得到了招募。对所有符合条件的患者进行监测，以评估发生的选择。通过与其中一名研究人员有直接专业联系的全科医生进行招募是一个积极的招募因素。
