Scott David, Reid Joanne, Hudson Peter, Martin Peter, Porter Sam
School of Nursing and Midwifery, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK.
Barwon Health, Geelong, VIC, Australia.
BMC Palliat Care. 2016 Dec 30;15(1):100. doi: 10.1186/s12904-016-0171-y.
Cachexia is defined as the on-going loss of skeletal muscle mass that cannot be fully reversed by conventional nutritional support. It is found in up to 80% of patients with advanced cancer and has profound psycho-social consequences for patients and their families. Previous studies demonstrate that many healthcare professionals receive little formal education in cachexia management leading them to feel that they have limited understanding of the syndrome and cannot intervene effectively. This study aims to examine the value of a dedicated cachexia clinic and its influence on staff understanding and practice.
An exploratory qualitative study was conducted. The study employed semi-structured interviews with a range of healthcare professionals responsible for designing and delivering cancer care in a large teaching hospital in Australia. This hospital had a dedicated cachexia clinic.
In-depth interviews were conducted with 8 healthcare professionals and senior managers. Four themes were identified: formal and informal education; knowledge and understanding; truth telling in cachexia and palliative care; and, a multi-disciplinary approach. Findings show that improved knowledge and understanding across a staff body can lead to enhanced staff confidence and a willingness to address cancer cachexia and its consequences with patients and their families.
Comparisons with similar previous research demonstrate the advantages of providing a structure for staff to gain knowledge about cachexia and how this can contribute to feelings of improved understanding and confidence necessary to respond to the challenge of cachexia.
恶病质被定义为骨骼肌质量持续流失,且无法通过传统营养支持完全逆转。在高达80%的晚期癌症患者中可发现恶病质,它会给患者及其家人带来深远的心理社会影响。先前的研究表明,许多医疗保健专业人员在恶病质管理方面接受的正规教育很少,这导致他们觉得自己对该综合征的了解有限,无法有效干预。本研究旨在探讨设立专门的恶病质诊所的价值及其对工作人员理解和实践的影响。
进行了一项探索性定性研究。该研究采用半结构化访谈,对象是澳大利亚一家大型教学医院中负责设计和提供癌症护理的一系列医疗保健专业人员。这家医院设有专门的恶病质诊所。
对8名医疗保健专业人员和高级管理人员进行了深入访谈。确定了四个主题:正规和非正规教育;知识与理解;恶病质和姑息治疗中的告知真相;以及多学科方法。研究结果表明,全体工作人员知识和理解的提高可增强工作人员的信心,并使他们愿意与患者及其家人讨论癌症恶病质及其后果。
与之前类似研究的比较表明,为工作人员提供了解恶病质知识的架构具有优势,这有助于增强理解感和信心,以应对恶病质带来的挑战。