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台湾的结直肠癌:病例对照回顾性分析病例管理方案对拒绝和中断治疗的影响。

Colorectal cancer in Taiwan: A case-control retrospective analysis of the impact of a case management programme on refusal and discontinuation of treatment.

机构信息

Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Graduate Institute of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.

出版信息

J Adv Nurs. 2018 Feb;74(2):395-406. doi: 10.1111/jan.13443. Epub 2017 Oct 4.

Abstract

AIMS

The purposes of this study were to identify the impact of a case management programme on the related factors of refusing treatment or discontinuing treatment in Taiwanese colorectal cancer patients.

BACKGROUND

Side effects of anti-cancer treatments are associated with refusing treatment and discontinuing treatment.

DESIGN

This case-control study, longitudinal database and secondary analysis of population-based data was conducted from 2009-2012.

METHODS

Logistic regression was used to reveal the factors related to refusing or discontinuing treatment.

RESULTS

Of the 68 patients who refused treatment, the top reasons for refusing treatment were patients or their family considered the patients poor physical condition, difficulty in enduring any condition likely to cause physical discomfort from the disease treatment, selected complementary and alternative medicine, patients or their families or friends experienced negative treatment effects and worried about the side effects of treatment, older age, poor family support and lost contact. Of the 278 patients who discontinued treatment, the most common reasons for discontinuing treatment were patients or their families or friends experienced negative treatment effects and worried about the side effects of treatment, inconvenient transportation, patients or their family considered the patients poor physical condition, difficulty in enduring any condition likely to cause physical discomfort from the disease treatment, poor treatment effect and selected complementary and alternative medicine.

CONCLUSION

Case managers can provide positive communication and available resources in relation to cancer treatment. A case management programme can help patients cope with the difficulties encountered during the treatment period.

摘要

目的

本研究旨在确定病例管理计划对台湾结直肠癌患者拒绝治疗或中断治疗相关因素的影响。

背景

抗癌治疗的副作用与拒绝治疗和中断治疗有关。

设计

本病例对照研究、纵向数据库和基于人群数据的二次分析于 2009-2012 年进行。

方法

使用逻辑回归揭示与拒绝或中断治疗相关的因素。

结果

在 68 名拒绝治疗的患者中,拒绝治疗的主要原因是患者或其家属认为患者身体状况不佳、难以忍受任何可能导致疾病治疗身体不适的情况、选择补充和替代医学、患者或其家属或朋友经历了负面的治疗效果并担心治疗的副作用、年龄较大、家庭支持较差和失去联系。在 278 名中断治疗的患者中,中断治疗最常见的原因是患者或其家属或朋友经历了负面的治疗效果并担心治疗的副作用、交通不便、患者或其家属认为患者身体状况不佳、难以忍受任何可能导致疾病治疗身体不适的情况、治疗效果不佳和选择补充和替代医学。

结论

病例经理可以提供与癌症治疗相关的积极沟通和可用资源。病例管理计划可以帮助患者应对治疗期间遇到的困难。

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