Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, China.
Seven Wards of General Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China.
Ann Palliat Med. 2020 May;9(3):985-992. doi: 10.21037/apm-20-851. Epub 2020 May 11.
The incidence of cancer has risen as the population has grown older. For patients with advanced cancer and limited survival, palliative care (PC) is especially urgent and important. In this study, we analyzed the knowledge, attitude, and behavior of oncology medical staff in PC at one hospital.
A questionnaire ("knowledge, Attitude and Behavior Questionnaire for PCs of Oncology Medical Staff") designed to investigate 167 oncology members of medical staff serving at the Affiliated Tumor Hospital of Harbin Medical University in China. After obtaining the consent of the respondents, a pair of questionnaires were sent and recovered.
(I) Awareness survey of oncologist medical staff members on PC of the four issues, the awareness part with Q2 (PC service should not be provided with cancer treatment at the same time) the highest accuracy, Q1-Q4 all correct proportion of 39.61%; (II) the majority of the oncology medical staff members questioned (73.38%) believed that when patients can no longer accept surgery, radiotherapy, chemotherapy and other anti-cancer treatment, when a patient's symptoms cannot be controlled (55.19%), or when estimated survival time is <3 months (57.76%), PC service should be accepted. Meanwhile, 28.57% of oncology medical staff believed that they would recommend PC to tumor patients on their first visit to the hospital, 18.83% thought that patients should be informed of the prognosis information, and 40.26% indicated that they were more willing to inform the patient's family/caregiver of the diagnosis and prognosis. In relation to behavior, more than half of respondents said that when conflict arises between patients who would prefer to stop receiving life-sustaining treatment and their family members, the will of the patient should be followed, while the implementation of cardiopulmonary resuscitation for patients with advanced tumors is situation-dependent. When the patient was no longer capable of making a decision and the intention of the family members was inconsistent with the patient's previously expressed preferences, 38.31% of the respondents claimed they would support the patient.
Members of oncology medical staffs have insufficient PC knowledge, and they should pay close attention to their knowledge, attitude, and behavior in relation to PC.
随着人口老龄化，癌症的发病率有所上升。对于晚期癌症和预期寿命有限的患者，姑息治疗（PC）尤为紧迫和重要。本研究分析了一家医院肿瘤科医务人员对 PC 的知识、态度和行为。
采用自行设计的调查问卷“肿瘤科医务人员 PC 知识、态度和行为调查问卷”，对哈尔滨医科大学附属肿瘤医院的 167 名肿瘤科医务人员进行调查。在获得调查对象同意后，发放并回收一对问卷。
（I）对肿瘤科医务人员 PC 四个问题的知晓情况调查，知晓部分以 Q2（PC 服务不应与癌症治疗同时提供）准确率最高，Q1-Q4 全部正确的比例为 39.61%；（II）大多数被调查的肿瘤科医务人员（73.38%）认为当患者不能再接受手术、放疗、化疗等抗癌治疗时，当患者的症状无法控制时（55.19%），或当预计生存时间<3 个月时（57.76%），应接受 PC 服务。同时，28.57%的肿瘤科医务人员认为他们会在肿瘤患者首次就诊时就向他们推荐 PC，18.83%的人认为应告知患者预后信息，40.26%的人表示更愿意告知患者的家属/照顾者诊断和预后情况。在行为方面，超过一半的受访者表示，当患者宁愿停止接受维持生命的治疗而其家属存在冲突时，应遵循患者的意愿，而对晚期肿瘤患者实施心肺复苏则视情况而定。当患者不再有能力做出决定，而家属的意愿与患者之前表达的偏好不一致时，38.31%的受访者表示会支持患者。
肿瘤科医务人员对 PC 的认识不足，应密切关注其对 PC 的知识、态度和行为。
