Education and Research Center for Clinical Pharmacy, Kyoto Pharmaceutical University, Kyoto, Japan.
Department of Pharmacy, Tachibana Medical Corporation 38428Higashisumiyoshimorimoto Hospital, Osaka, Japan.
Am J Hosp Palliat Care. 2021 Mar;38(3):283-290. doi: 10.1177/1049909120944157. Epub 2020 Jul 24.
Few studies evaluated whether health care professionals accurately assess several symptoms for patients with cancer in palliative care units. We determined the agreement level for several symptoms related to quality of life (QOL) between patient-reported QOL assessment and health care professional-assessed symptoms based on the Support Team Assessment Schedule (STAS).
An observational study was performed with terminally ill patients with cancer hospitalized in the palliative care unit between June 2018 and December 2019. Patients and health care professionals independently assessed 7 symptoms at the time of hospitalization and after 1 week. Patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C15-PAL). In examining the proportions of exact agreement, "exact agreement" referred to the pairs of the scores (QLQ-C15-PAL vs STAS) being (1 vs 0), (2 vs 1), (3 vs 2 or 3), or (4 vs 4). The relationships of physical functioning between QLQ-C15-PAL and Palliative Performance Scale (PPS) were examined.
Of 130 patients, approximately 60% had PPS scores from 40 to 60. The highest mean score on QLQ-C15-PAL was for fatigue (63.8). The exact agreement on symptoms between patients and health care professionals ranged from 15.4% (fatigue) to 57.7% (nausea and vomiting). The mean of the transformed QLQ-C15-PAL and proportions of exact agreement were negatively correlated ( = 0.949, < .05). The physical function scores in QLQ-C15-PAL for each PPS group showed no differences.
We expect patient-reported outcomes including QLQ-C15-PAL to be added to health care professionals' assessment of serious symptoms such as fatigue in terminally ill patients with cancer.
很少有研究评估姑息治疗病房的医护人员是否能准确评估癌症患者的多种症状。我们根据支持治疗评估计划（STAS），确定了患者报告的生活质量（QOL）评估与医护人员评估的多种症状之间的一致性水平。
这是一项观察性研究，纳入了 2018 年 6 月至 2019 年 12 月期间在姑息治疗病房住院的终末期癌症患者。患者和医护人员在入院时和入院后 1 周分别独立评估了 7 种症状。患者完成欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ-C15-PAL）。在检查精确一致性的比例时，“精确一致性”指的是评分（QLQ-C15-PAL 与 STAS）的分数（1 对 0）、（2 对 1）、（3 对 2 或 3）或（4 对 4）。还检查了 QLQ-C15-PAL 与姑息治疗状况量表（PPS）之间的身体功能关系。
在 130 名患者中，约 60%的患者 PPS 评分在 40 到 60 之间。QLQ-C15-PAL 的最高平均得分为疲劳（63.8）。患者与医护人员对症状的精确一致性范围为 15.4%（疲劳）至 57.7%（恶心和呕吐）。转化后的 QLQ-C15-PAL 的平均值和精确一致性的比例呈负相关（ = 0.949， <.05）。在 QLQ-C15-PAL 中，每个 PPS 组的身体功能评分无差异。
我们预计包括 QLQ-C15-PAL 在内的患者报告结局将被添加到医护人员对终末期癌症患者严重症状（如疲劳）的评估中。
