Brown Christine, Drosdowsky Allison, Krishnasamy Meinir
Intensive Care Unit, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria, 3000, Australia.
Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, Victoria, 3000, Australia.
Eur J Oncol Nurs. 2017 Dec;31:77-83. doi: 10.1016/j.ejon.2017.10.005. Epub 2017 Nov 6.
Recent advances in cancer therapies offer survival benefit when cure is no longer possible. The contribution of the Medical Emergency Teams (METs) in the context of advancing disease has received little empirical consideration. This study set out to explore MET intervention at the end of life for people with advanced cancer in an Australian comprehensive cancer centre, and its impact on quality of death.
A retrospective medical chart review was undertaken to explore MET response for people with advanced (incurable) cancer nearing end of life. Occurrence of MET interventions at the end of life and a quality of death score were recorded for two randomly selected cohorts of patients, those who experienced a MET response within their last week of life (n = 50) and those who did not (n = 50).
The cohort who did not receive MET intervention had a significantly higher (better) quality of death score when compared with patients who did receive a MET intervention (p = 0.01). Within the cohort who received a MET intervention, a subgroup (n = 19) where the MET influenced end-of-life decision-making had a significantly higher quality of death score (p = 0.02) than patients in the MET cohort (n = 31) where the MET did not influence end-of-life care.
The contribution of the MET to end-of-life care for patients with cancer has not previously been reported. Further research is now needed to prospectively examine MET involvement at the end of life with consideration to quality of patient care and death, family experience, and support requirements of MET members.
当癌症无法治愈时,癌症治疗的最新进展能带来生存益处。在疾病进展的情况下,医疗急救团队(METs)的作用很少得到实证研究。本研究旨在探讨澳大利亚一家综合癌症中心中,METs对晚期癌症患者临终时的干预及其对死亡质量的影响。
进行了一项回顾性病历审查,以探究METs对接近生命末期的晚期(无法治愈)癌症患者的反应。记录了两个随机选择的患者队列在临终时MET干预的发生情况和死亡质量评分,一组是在生命最后一周内经历了MET反应的患者(n = 50),另一组是未经历MET反应的患者(n = 50)。
与接受MET干预的患者相比,未接受MET干预的队列的死亡质量评分显著更高(更好)(p = 0.01)。在接受MET干预的队列中,MET影响临终决策的一个亚组(n = 19)的死亡质量评分显著高于MET未影响临终护理的MET队列患者(n = 31)(p = 0.02)。
此前尚未报道METs对癌症患者临终护理的贡献。现在需要进一步开展前瞻性研究,以考察METs在临终时的参与情况,并考虑患者护理和死亡质量、家庭体验以及MET成员的支持需求。