伊巴丹成年癌症患者的居家姑息治疗——三年回顾
Home-based palliative care for adult cancer patients in Ibadan-a three year review.
作者信息
Omoyeni Ne, Soyannwo Oa, Aikomo Oo, Iken Of
机构信息
Hospice and Palliative Care Unit, University College Hospital (UCH), PMB 5116, Ibadan, Oyo 200212, Nigeria.
出版信息
Ecancermedicalscience. 2014 Dec 11;8:490. doi: 10.3332/ecancer.2014.490. eCollection 2014.
UNLABELLED
Home-based palliative care is a recognised model of health service provision globally, but is just emerging in Nigeria. The aim of this study isto review the spectrum of adult cancer patients involved in home-based palliative care, the services provided, outcome and benefits.
METHODS
Records of all adult cancer patients seen on home-based palliative care between March 2009 and January 2013 by the hospice and palliative care unit, University College Hospital (UCH), Ibadan were reviewed. Their biographical data, days on programme, diagnosis, stage of disease, major complaint, pain score, other symptoms, services offered, number of home visits, follow-up, and outcomes were extracted, reviewed, and analysed. The data were analysed using SPSS version 16.0.
RESULTS
Sixty patients were enrolled during the study period: there were 20 (33.3%) males and 40 (66.7%) females out of a total of 787 patients. All of them reside within catchment area of the hospice. Breast and prostate cancer constitute 21.7% each, gastrointestinal 16.7%, liver 11.7%, and cervical cancer 10.0%. Homes were visited 1-23 times per person. Days on programme ranged from 9-1207 days (average: 286 days). Pain was reported by 52 (86.7%) with scores of 7 to10 in 26 (50.0%). Only eight (13.3%) were pain-free. Services offered included pain and other symptom control, counselling and training for carers at home, provision of funds and comfort packs, bereavement services. The cost of services was heavily subsidised by the Centre for Palliative Care, Nigeria (CPCN), a non-governmental organisation and UCH. Although all patients are now deceased, the compassionate care received at a subsidised cost was highly valued, as shown from the appreciative comments of relations and carers.
CONCLUSION
Home-based palliative care provided at low cost was beneficial to patients and their families. More can be achieved through the training of more health professionals, increased funding, and increased public awareness of the services.
未标注
居家姑息治疗是全球公认的一种医疗服务模式，但在尼日利亚刚刚兴起。本研究的目的是回顾参与居家姑息治疗的成年癌症患者的情况、所提供的服务、结果及益处。
方法
回顾了2009年3月至2013年1月期间，伊巴丹大学学院医院临终关怀与姑息治疗科对所有接受居家姑息治疗的成年癌症患者的记录。提取、回顾并分析了他们的传记资料、治疗天数、诊断、疾病分期、主要症状、疼痛评分、其他症状、提供的服务、家访次数、随访情况及结果。数据使用SPSS 16.0版本进行分析。
结果
研究期间共纳入60例患者：在总共787例患者中，男性20例（33.3%），女性40例（66.7%）。他们均居住在临终关怀机构的服务区域内。乳腺癌和前列腺癌各占21.7%，胃肠道癌占16.7%，肝癌占11.7%，宫颈癌占10.0%。每人家访次数为1 - 23次。治疗天数为9 - 1207天（平均：286天）。52例（86.7%）报告有疼痛，其中26例（50.0%）疼痛评分为7至10分。只有8例（13.3%）无疼痛。提供的服务包括疼痛及其他症状控制、在家为护理人员提供咨询和培训、提供资金和安慰包、丧亲服务。服务费用由尼日利亚姑息治疗中心（CPCN，一个非政府组织）和大学学院医院大量补贴。尽管所有患者现已去世，但亲属和护理人员的感激评论表明，以补贴价格获得的关怀护理受到高度重视。
结论
低成本的居家姑息治疗对患者及其家庭有益。通过培训更多的卫生专业人员、增加资金投入以及提高公众对这些服务的认识，可以取得更大的成效。
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