Bergerot Cristiane Decat, Philip Errol J, Bergerot Paulo Gustavo, Elias Simone, Guimarães Daiane Pereira, Forones Nora Manoukian, Baiocchi Otavio Cesar Carvalho Guimarães, Batista Nildo Alves, De Domenico Edvane Birelo Lopes
, , , , , , , and , Universidade Federal de São Paulo, São Paulo, Brazil; and , University of Notre Dame, Notre Dame, IN.
J Glob Oncol. 2016 Sep 21;3(3):189-193. doi: 10.1200/JGO.2016.006148. eCollection 2017 Jun.
It has become crucial to translate scientific findings and to find ways by which to mobilize local resources to improve the quality and accessibility of cancer care in developing countries. This study seeks to provide insight into challenge through examining differences in clinician documentation of patients with cancer treated at a Brazilian Public University Hospital.
ASCO Quality Oncology Practice Initiative (QOPI) measures were used to examine the care provided in the departments of breast, colorectal, lymphoma, gynecology, and lung cancers. For this study, data from a representative sample of patients receiving chemotherapy in the previous month were extracted and quality of cancer care indicators examined.
Certain elements of medical care were consistently and appropriately documented, including cancer diagnosis and stage, chemotherapy planning, administration, and summary. In general, considering the specific cancer management measures, patients received recommended care in accordance with recognized guidelines. Despite this, a number of important gaps in care were identified, including the assessment and treatment of pain, documentation of chemotherapy intention, symptom and toxicity management, patients' psychosocial status, and provision of a treatment summary at care completion.
These findings are encouraging in terms of adherence to core treatment guidelines in cancer care in Brazil. However, results suggest important opportunities for improving care across a number of domains, many of which represent a challenge throughout both developing and developed countries. This study may also provide preliminary guidance for enhancing educational and training programs for professionals and students alike, to implement high-quality, comprehensive cancer care.
将科学研究成果进行转化,并找到调动当地资源以提高发展中国家癌症护理质量和可及性的方法,已变得至关重要。本研究旨在通过考察巴西一所公立大学医院中接受治疗的癌症患者的临床医生记录差异,深入了解其中所面临的挑战。
采用美国临床肿瘤学会(ASCO)肿瘤学质量实践倡议(QOPI)指标,对乳腺癌、结直肠癌、淋巴瘤、妇科癌和肺癌科室所提供的护理进行考察。在本研究中,提取了上个月接受化疗的具有代表性的患者样本数据,并对癌症护理指标的质量进行了检查。
医疗护理的某些要素得到了持续且恰当的记录,包括癌症诊断及分期、化疗计划、实施及总结。总体而言,就具体的癌症管理措施而言,患者接受了符合公认指南的推荐护理。尽管如此,仍发现了一些重要的护理差距,包括疼痛评估与治疗、化疗意向记录、症状及毒性管理、患者心理社会状况以及护理结束时提供治疗总结。
就巴西癌症护理中对核心治疗指南的遵循情况而言,这些发现令人鼓舞。然而,结果表明在多个领域存在改善护理的重要机会,其中许多领域在发展中国家和发达国家都构成挑战。本研究还可为加强针对专业人员和学生的教育及培训项目提供初步指导,以实施高质量、全面的癌症护理。