QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia.
Centre for Aboriginal Studies, Curtin University, Bentley, WA, Australia.
Support Care Cancer. 2021 Apr;29(4):2073-2082. doi: 10.1007/s00520-020-05714-4. Epub 2020 Aug 29.
Indigenous Australians diagnosed with cancer have substantially higher cancer mortality rates compared with non-Indigenous Australians, yet there is a paucity of information about their end-of-life service utilisation and supportive care needs.
To describe the service utilisation and supportive care needs of Aboriginal and Torres Strait Islander people with cancer at end-of-life.
Hospital admission data were linked to self-reported data from a study of Indigenous cancer patients from Queensland, Australia during the last year of their life. Needs were assessed by the Supportive Care Needs Assessment Tool for Indigenous Cancer Patients which measures 26 need items across 4 domains (physical/psychological; hospital care; information/communication; practical/cultural). A descriptive analysis of health service utilisation and unmet needs was conducted.
In total, 58 Indigenous cancer patients were included in this analysis. All patients had at least one hospital admission within the last year of their life. Most hospital admissions occurred through emergency (38%) and outpatient (31%) departments and were for acute care (85%). Palliative care represented 14% of admissions and 78% died in hospital. Approximately half (48%) did not report any unmet needs. The most frequently reported moderate-to-high unmet need items were worry about the treatment results (17%), money worries (16%) and anxiety (16%).
Utilisation of palliative care services that manage a full range of physical and psychosocial needs was low. Addressing worries about treatment results, finances and generalised anxiety are priorities in this population.
与非原住民澳大利亚人相比，被诊断患有癌症的澳大利亚原住民的癌症死亡率要高得多，但关于他们在生命末期的服务利用和支持性护理需求的信息却很少。
描述澳大利亚昆士兰州癌症末期的原住民和托雷斯海峡岛民的服务利用和支持性护理需求。
将住院数据与澳大利亚昆士兰州的一项研究中来自原住民癌症患者的自我报告数据进行了关联，这些患者在生命的最后一年中接受了研究。使用原住民癌症患者支持性护理需求评估工具评估需求，该工具衡量了 4 个领域（身体/心理；医院护理；信息/沟通；实际/文化）的 26 项需求项目。对卫生服务利用和未满足的需求进行了描述性分析。
本分析共纳入了 58 名原住民癌症患者。所有患者在生命的最后一年中至少有一次住院治疗。大多数住院治疗发生在急诊（38%）和门诊（31%）科室，是急性护理（85%）。姑息治疗占住院治疗的 14%，78%的患者在医院死亡。大约有一半（48%）的患者没有报告任何未满足的需求。报告的中度至高度未满足需求项目中最常见的是担心治疗结果（17%）、经济担忧（16%）和焦虑（16%）。
姑息治疗服务的利用率较低，这些服务可以管理全面的身体和心理社会需求。解决对治疗结果、财务和普遍焦虑的担忧是该人群的优先事项。
