1 Section of Palliative Care and Medical Ethics , Pittsburgh, Pennsylvania.
J Palliat Med. 2014 Jun;17(6):667-72. doi: 10.1089/jpm.2013.0537. Epub 2014 Mar 27.
It is not known whether unmet palliative care needs are associated with an interest in palliative care services among patients with advanced cancer receiving ongoing oncology care.
To assess the association between unmet palliative care needs and patient interest in subspecialty palliative care services.
Cross-sectional telephone survey.
One hundred sixty-nine patients with advanced cancer receiving care from 20 oncologists at two academic cancer centers.
Surveys assessed palliative care needs in six domains. Patients were read a description of palliative care and then asked three questions about their current interest in subspecialty palliative care services (perceived need, likelihood of requesting, willingness to see if their oncologist recommended; all outcomes on 0-10 Likert scale).
The vast majority of patients described unmet palliative care needs, most commonly related to psychological/emotional distress (62%) and symptoms (62%). In fully adjusted models accounting for clustering by oncologist, unmet needs in these domains were associated with a higher perceived need for subspecialty palliative care services (psychological/emotional needs odds ratio [OR] 1.30; 95% confidence interval [CI] 1.06-1.58; p=0.01; symptom needs OR 1.27; 95% CI 1.01-1.60; p=0.04). There was no significant association between unmet needs and likelihood of requesting palliative care services. Willingness to see palliative care if oncologist recommended was high (mean 8.6/10, standard deviation [SD] 2).
Patients with advanced cancer and unmet symptom and psychological/emotional needs perceive a high need for subspecialty palliative care services but may not request them. Efforts to increase appropriate use of subspecialty palliative care for cancer may require oncologist-initiated referrals.
目前尚不清楚在接受持续肿瘤学治疗的晚期癌症患者中，未满足的姑息治疗需求是否与对姑息治疗服务的兴趣相关。
评估未满足的姑息治疗需求与患者对专科姑息治疗服务的兴趣之间的关系。
横断面电话调查。
169 名在两家学术癌症中心的 20 名肿瘤学家处接受治疗的晚期癌症患者。
调查评估了六个领域的姑息治疗需求。向患者阅读了姑息治疗的描述，然后询问了三个关于他们当前对专科姑息治疗服务的兴趣的问题（感知需求、请求的可能性、愿意在其肿瘤医生建议时就诊；所有结果均为 0-10 级 Likert 量表）。
绝大多数患者描述了未满足的姑息治疗需求，最常见的是与心理/情绪困扰（62%）和症状（62%）相关。在充分调整了按肿瘤医生聚类的模型中，这些领域的未满足需求与对专科姑息治疗服务的更高感知需求相关（心理/情绪需求的优势比 [OR] 1.30；95%置信区间 [CI] 1.06-1.58；p=0.01；症状需求 OR 1.27；95% CI 1.01-1.60；p=0.04）。未满足的需求与请求姑息治疗服务的可能性之间没有显著关联。如果肿瘤医生建议，愿意就诊姑息治疗的意愿很高（平均值为 8.6/10，标准差 [SD] 2）。
患有晚期癌症且有未满足的症状和心理/情绪需求的患者感知对专科姑息治疗服务有很高的需求，但可能不会请求。为增加癌症专科姑息治疗的适当使用而进行的努力可能需要肿瘤医生主动转介。
