Day Rebecca, Mitchell Theresa, Keen Alison, Perkins Paul
Research Department, Sue Ryder Leckhampton Court Hospice, Cheltenham, UK.
Palliat Med. 2013 Sep;27(8):739-46. doi: 10.1177/0269216313480400. Epub 2013 Apr 4.
Ascites secondary to cancer has a dramatic effect on all aspects of patients' lives. Healthcare professional surveys have shown that there is considerable variation in the management of ascites.
To explore patients' experiences of living with ascites and its management.
Qualitative research study using digitally recorded semi-structured interviews.
SETTING/PARTICIPANTS: Twelve adult patients with ascites who, between them, had undergone 47 paracentesis procedures in hospitals and/or specialist palliative care units in Southern England.
Symptoms were pain, discomfort and effects on appetite, digestion, breathing and mobility. All participants had experienced paracentesis in hospital or a specialist palliative care unit, and these experiences differed. They had views on what constituted a good procedure: setting, competence and pain control. They reported rapid improvement of symptoms after paracentesis. While some did not like the idea of a semi-permanent drain, those with them appreciated the convenience and not having to wait for repeated admissions or the recurrence of symptoms. The interval between ascitic taps was seen as a useful guide as to when a semi-permanent drain should be offered. Participants had mixed views on participation in a hypothetical randomised controlled trial of repeated ascitic taps versus semi-permanent drains.
Patients' experiences of ascites management are variable and could be improved. These experiences can inform healthcare professionals. They have views on when semi-permanent drains should be offered and future research.
癌症继发腹水对患者生活的各个方面都有显著影响。医疗专业人员调查显示,腹水管理存在很大差异。
探讨患者腹水生活经历及其管理情况。
采用数字记录的半结构化访谈进行定性研究。
地点/参与者:12名成年腹水患者,他们在英格兰南部的医院和/或专科姑息治疗单位共接受了47次腹腔穿刺术。
症状包括疼痛、不适以及对食欲、消化、呼吸和行动能力的影响。所有参与者都在医院或专科姑息治疗单位经历过腹腔穿刺术,且这些经历各不相同。他们对什么是良好的操作有看法:环境、能力和疼痛控制。他们报告腹腔穿刺术后症状迅速改善。虽然有些人不喜欢半永久性引流管的想法,但使用过的人赞赏其便利性,且无需等待反复住院或症状复发。腹水穿刺间隔时间被视为决定何时应提供半永久性引流管的有用指导。参与者对参与重复腹腔穿刺术与半永久性引流管的假设随机对照试验看法不一。
患者腹水管理经历各不相同,有待改善。这些经历可为医疗专业人员提供参考。他们对半永久性引流管的提供时机及未来研究有看法。