Scaccabarozzi Gianlorenzo, Amodio Emanuele, Riva Luca, Corli Oscar, Maltoni Marco, Di Silvestre Grazia, Turriziani Adriana, Morino Piero, Pellegrini Giacomo, Crippa Matteo
Dipartimento Fragilità/Rete Locale Cure palliative, ASST Lecco, 23807 Merate (LC), Italy.
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133 Palermo, Italy.
Healthcare (Basel). 2020 Jul 20;8(3):221. doi: 10.3390/healthcare8030221.
In order to plan the right palliative care for patients and their families, it is essential to have detailed information about patients' needs. To gain insight into these needs, we analyzed five Italian local palliative care networks and assessed the clinical care conditions of patients facing the complexities of advanced and chronic disease. A longitudinal, observational, noninterventional study was carried out in five Italian regions from May 2017 to November 2018. Patients who accessed the palliative care networks were monitored for 12 months. Sociodemographic, clinical, and symptom information was collected with several tools, including the Necesidades Paliativas CCOMS-ICO (NECPAL) tool, the Edmonton Symptom Assessment System (ESAS), and interRAI Palliative Care (interRAI-PC). There were 1013 patients in the study. The majority (51.7%) were recruited at home palliative care units. Cancer was the most frequent diagnosis (85.4%), and most patients had at least one comorbidity (58.8%). Cancer patients reported emotional stress with severe symptoms (38.7% vs. 24.3% in noncancer patients; = 0.001) and were less likely to have clinical frailty (13.3% vs. 43.9%; < 0.001). Our study confirms that many patients face the last few months of life with comorbidities or extreme frailty. This study contributes to increasing the general knowledge on palliative care needs in a high-income country.
为了为患者及其家属规划合适的姑息治疗，掌握患者需求的详细信息至关重要。为深入了解这些需求，我们分析了五个意大利地方姑息治疗网络，并评估了面临晚期和慢性疾病复杂性的患者的临床护理状况。2017年5月至2018年11月在意大利五个地区开展了一项纵向、观察性、非干预性研究。对进入姑息治疗网络的患者进行了12个月的监测。使用多种工具收集了社会人口统计学、临床和症状信息，包括姑息治疗需求CCOMS - ICO（NECPAL）工具、埃德蒙顿症状评估系统（ESAS）和互操作性居家照护评估量表（interRAI - PC）。该研究共有1013名患者。大多数患者（51.7%）是在家中姑息治疗单位招募的。癌症是最常见的诊断疾病（85.4%），大多数患者至少有一种合并症（58.8%）。癌症患者报告有严重症状的情绪压力（38.7%对比非癌症患者的24.3%；P = 0.001），且临床衰弱的可能性较小（13.3%对比43.9%；P < 0.001）。我们的研究证实，许多患者在生命的最后几个月面临合并症或极度衰弱。这项研究有助于增加对高收入国家姑息治疗需求的总体认识。
