Musiello Toni, Dixon Glenys, O'Connor Moira, Cook Deb, Miller Lisa, Petterson Anna, Saunders Christobel, Joske David, Johnson Claire
School of Surgery, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia.
School of Psychology and Speech Pathology, Curtin University, Kent St, Bentley, Western Australia 6102, Australia.
Appl Nurs Res. 2017 Feb;33:15-18. doi: 10.1016/j.apnr.2016.09.005. Epub 2016 Sep 24.
To explore the: 1) prevalence of distress, type of problems experienced by haematological patients, and referrals for supportive care; 2) effect of demographic and clinical variables on distress, and 3) effect on the time of health professionals conducting the screening in the ambulatory chemotherapy setting.
Participants completed the National Comprehensive Cancer Network Distress Thermometer and Problem List and had a follow-up screening discussion with a health professional.
Of 68 participants, 40% reported significant distress (≥4) on the Distress Thermometer (mean 3.2, SD 2.4). All patients reported physical problems and 72% reported emotional problems-the major contributors to distress and to time spent with the health professional. Distress was unrelated to age, gender or cancer type. Patients were less likely to have significant distress at the end of treatment than at the beginning (OR=0.15, 95% CI: 0.03; 0.72,). Forty patients (59%) were referred to supportive services. The psychologist spent less time with patients compared to the nurse (18 vs 48min, p<0.001). The more emotional problems reported, the greater the time spent with the patient (r=0.34, p=0.009).
Nurses can appropriately screen for distress and address significant distress reported by haematology patients undergoing chemotherapy without over burdening the nurse or patient.
探讨:1)血液学患者的痛苦发生率、所经历问题的类型以及支持性护理的转诊情况;2)人口统计学和临床变量对痛苦的影响;3)对门诊化疗环境中进行筛查的卫生专业人员的时间影响。
参与者完成了美国国立综合癌症网络痛苦温度计和问题清单,并与卫生专业人员进行了后续筛查讨论。
在68名参与者中,40%在痛苦温度计上报告有显著痛苦(≥4)(平均3.2,标准差2.4)。所有患者均报告有身体问题,72%报告有情绪问题,这些是痛苦以及与卫生专业人员相处时间的主要影响因素。痛苦与年龄、性别或癌症类型无关。与治疗开始时相比,患者在治疗结束时出现显著痛苦的可能性较小(比值比=0.15,95%置信区间:0.03;0.72)。40名患者(59%)被转诊至支持性服务机构。与护士相比,心理学家与患者相处的时间较少(18分钟对48分钟,p<0.001)。报告的情绪问题越多,与患者相处的时间就越长(r=0.34,p=0.009)。
护士可以适当地筛查痛苦,并处理接受化疗的血液学患者报告的显著痛苦,而不会给护士或患者造成过重负担。