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儿童癌症治疗负担:一项使用已故儿童病历的定量研究。

Burden of treatment in the face of childhood cancer: A quantitative study using medical records of deceased children.

作者信息

Rost Michael, Wangmo Tenzin, Rakic Milenko, Acheson Elaine, Rischewski Johannes, Hengartner Heinz, Kühne Thomas, Elger Bernice S

机构信息

Institute for Biomedical Ethics, University of Basel, Basel, Switzerland.

Pediatric Oncology and Hematology, Children's Hospital, Lucerne, Switzerland.

出版信息

Eur J Cancer Care (Engl). 2018 Nov;27(6):e12879. doi: 10.1111/ecc.12879. Epub 2018 Jul 24.

Abstract

Lived experiences of childhood cancer patients and their families have been described as interrupted and as a loss of normal life. Apart from symptoms due to the cancer disease, families continuously experience burden of treatment. Since coping capacities are unique to each individual, we captured variables that offer objective measures of treatment burden, with a particular focus on the disruptive effects of treatment on families' lives. Our sample was comprised by 193 children that died of cancer. Medical records were extracted retrospectively. Quantitative data were statistically analysed with respect to variables related to treatment burden. Deceased children with cancer and their families faced a significant burden of treatment. Results revealed that deceased leukaemia patients had a higher number of inpatient stays, spent more time in the hospital both during their illness and during the last month of their life, and were more likely to die in the hospital when compared to deceased patients with CNS neoplasms and with other diagnoses. Our findings highlight the disruptive effects of treatment that are likely to have a great impact on families' daily life, that go beyond exclusively focusing on side effects, and that needs to be taken into account by the treating staff.

摘要

儿童癌症患者及其家庭的生活经历被描述为受到干扰,失去了正常生活。除了癌症疾病带来的症状外,家庭还持续承受着治疗负担。由于应对能力因人而异,我们收集了一些能够客观衡量治疗负担的变量,特别关注治疗对家庭生活的干扰影响。我们的样本包括193名死于癌症的儿童。医疗记录是回顾性提取的。对与治疗负担相关的变量进行了定量数据统计分析。患癌死亡儿童及其家庭面临着巨大的治疗负担。结果显示,与死于中枢神经系统肿瘤和其他诊断的患者相比,死于白血病的患者住院次数更多,在患病期间和生命的最后一个月在医院花费的时间更长,并且更有可能在医院死亡。我们的研究结果突出了治疗的干扰影响,这种影响可能对家庭日常生活产生重大影响,不仅仅局限于副作用,治疗人员需要予以考虑。

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