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癌症幸存者的康复:我们如何减少中低收入国家医疗保健服务的不平等。

Rehabilitation for Cancer Survivors: How We Can Reduce the Healthcare Service Inequality in Low- and Middle-Income Countries.

机构信息

From the Division of Surgical Oncology Department of Surgery, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia (SLA); Graduate Program, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia (SLA, BN); PILAR (Philippine and Indonesian Scholar) Research and Education, Cambridge, United Kingdom (SLA, WW); Department of Rehabilitation Medicine, Rumah Sakit Akademik, Universitas Gadjah Mada, Yogyakarta, Indonesia (GA); MRC Unit for Lifelong Health and Ageing, University College London, London, United Kingdom (WW); and Department of Rehabilitation Medicine, Hannover Medical School, Hannover, Germany (CG, BN).

出版信息

Am J Phys Med Rehabil. 2018 Oct;97(10):764-771. doi: 10.1097/PHM.0000000000000982.

Abstract

Cancer diagnosis often substantially affects patient's physical, psychological, and emotional status. Most patients with cancer experience declining of energy, activity levels, social-cultural participation, and relationships. In addition, cancer progression and adverse effects of aggressive cancer treatment often cause debilitating pain, fatigue, weakness, joint stiffness, depression, emotional instability, limited mobility, poor nutritional status, skin breakdown, bowel dysfunction, swallowing difficulty, and lymphedema leading into functional impairment and disability that can be addressed through rehabilitation care. Comprehensive care models by involving cancer rehabilitation have resulted in significant improvement of patient's quality of life. Although cancer rehabilitation has been implemented in many high-income countries, it is either not yet or suboptimally delivered in most low- and middle-income countries. In this review, we discussed gaps regarding cancer rehabilitation services and identified opportunities to improve quality of cancer care in developing countries. Future collaborations among international organizations and stakeholders of health care delivery systems are required to initiate and improve high-quality cancer rehabilitation in the developing countries.

摘要

癌症诊断通常会极大地影响患者的身体、心理和情绪状况。大多数癌症患者会经历精力、活动水平、社会文化参与度和人际关系的下降。此外,癌症的进展和侵袭性癌症治疗的副作用常导致使人衰弱的疼痛、疲劳、虚弱、关节僵硬、抑郁、情绪不稳定、活动能力受限、营养状况不佳、皮肤破损、肠道功能障碍、吞咽困难和淋巴水肿,进而导致功能障碍和残疾,这些问题可以通过康复护理来解决。通过癌症康复来实施综合护理模式,显著改善了患者的生活质量。尽管癌症康复已在许多高收入国家实施,但在大多数低收入和中等收入国家,要么尚未实施,要么实施效果不佳。在这篇综述中,我们讨论了癌症康复服务方面的差距,并确定了改善发展中国家癌症护理质量的机会。需要国际组织和医疗保健提供系统利益相关者之间开展未来合作,以便在发展中国家启动和改善高质量的癌症康复。

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