Kenis C, Heeren P, Decoster L, Van Puyvelde K, Conings G, Cornelis F, Cornette P, Moor R, Luce S, Libert Y, Van Rijswijk R, Jerusalem G, Rasschaert M, Langenaeken C, Baitar A, Specenier P, Geboers K, Vandenborre K, Debruyne P R, Vanoverbeke K, Van den Bulck H, Praet J-P, Focan C, Verschaeve V, Nols N, Goeminne J-C, Petit B, Lobelle J-P, Flamaing J, Milisen K, Wildiers H
Hans Wildiers, Herestraat 49, 3000 Leuven, Belgium, Tel.: +32 16 34 69 20, Fax.: +32 16 34 69 01, E-mail address:
J Nutr Health Aging. 2016 Jan;20(1):60-70. doi: 10.1007/s12603-016-0677-2.
The aim of this study is to describe a large-scale, Belgian implementation project about geriatric assessment (=GA) in daily oncology practice and to identify barriers and facilitators for implementing GA in this setting. Design / setting / participants: The principal investigator of every participating hospital (n=22) was invited to complete a newly developed questionnaire with closed- and open-ended questions. The closed-ended questions surveyed how GA was implemented. The open-ended questions identified barriers and facilitators for the implementation of GA in daily oncology practice. Descriptive statistics and conventional content analysis were performed as appropriate.
Qualifying criteria (e.g. disease status and cancer type) for GA varied substantially between hospitals. Thirteen hospitals (59.1%) succeeded to screen more than half of eligible patients. Most hospitals reported that GA data and follow-up data had been collected in almost all screened patients. Implementing geriatric recommendations and formulating new geriatric recommendations at the time of follow-up are important opportunities for improvement. The majority of identified barriers were organizational, with high workload, lack of time or financial/staffing problems as most cited. The most cited facilitators were all related to collaboration.
Interventions to improve the implementation of GA in older patients with cancer need to address a wide range of factors, with organization and collaboration as key elements. All stakeholders, seeking to improve the implementation of GA in older patients with cancer, should consider and address the identified barriers and facilitators.
本研究旨在描述一个在比利时日常肿瘤学实践中开展的关于老年评估(GA)的大规模实施项目,并确定在这种情况下实施GA的障碍和促进因素。设计/背景/参与者:邀请了每家参与医院(n = 22)的主要研究者填写一份新开发的包含封闭式和开放式问题的问卷。封闭式问题调查了GA是如何实施的。开放式问题确定了在日常肿瘤学实践中实施GA的障碍和促进因素。酌情进行描述性统计和传统内容分析。
各医院之间GA的合格标准(如疾病状态和癌症类型)差异很大。13家医院(59.1%)成功筛查了一半以上的 eligible patients。大多数医院报告称,几乎所有筛查患者都收集了GA数据和随访数据。在随访时实施老年医学建议并制定新的老年医学建议是重要的改进机会。确定的障碍大多是组织性的,最常被提及的是工作量大、时间不足或财务/人员配备问题。最常被提及的促进因素都与合作有关。
改善老年癌症患者GA实施情况的干预措施需要解决广泛的因素,其中组织和合作是关键要素。所有寻求改善老年癌症患者GA实施情况的利益相关者都应考虑并解决已确定的障碍和促进因素。