Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Av. Cuauhtemoc 330, Col. Doctores, Del. Cuauhtemoc, Mexico City, CP, 06720, Mexico.
Division of Social Protection and Health, Jamaica Country Office, Interamerican Development Bank, Kingston, Jamaica.
Eur J Oncol Nurs. 2020 Dec;49:101857. doi: 10.1016/j.ejon.2020.101857. Epub 2020 Oct 16.
To assess the supportive care needs (SC-needs), quality of patient-centered care (PCC), and factors associated with increased SC-needs of patients with lung cancer (LC) in Mexico.
We conducted a cross-sectional survey in the main oncology hospital of the Mexican Institute of Social Security in Mexico City. The study included LC ambulatory patients aged ≥18 years with at least one hospitalization before the survey, ≤five years since diagnosis, and without memory loss. Participants answered SC-needs and quality of PCC questionnaires. We performed a multiple negative binomial regression analysis to evaluate the factors associated with an increased number of SC-needs.
One hundred twenty-eight LC patients participated. Most participants had adenocarcinoma (61.7%) and were at an advanced disease stage (92.1%). In the month preceding the survey, 3.9% had undergone surgery and 78.9% had been receiving chemotherapy and/or radiotherapy; 28.9% had symptoms of depression and 21.9% had anxiety. All patients reported one or more SC-needs-predominantly physical, daily living, information, and psychological needs. The significant gaps in PCC-quality were in the domains of care that addressed biopsychosocial needs and information for treatment decision-making. Factors that decreased the probability of SC-needs were respectful and coordinated care, high-school education, and older age. The factors increasing the likelihood of SCneeds were the type of LC (adenocarcinoma, mesenchymal tumors), chemotherapy and/or radiotherapy, and anxiety.
PCC improvement initiatives to address SC-needs of LC patients should be prioritized and focus on: (1) information on physical suffering relief and treatment; (2) psychological support; and (3) SC-needs monitoring.
评估墨西哥肺癌(LC)患者的支持性护理需求(SC-needs)、以患者为中心的护理质量(PCC)以及与 SC-needs 增加相关的因素。
我们在墨西哥社会保障研究所的主要肿瘤医院进行了一项横断面调查。该研究纳入了年龄≥18 岁、至少有一次住院治疗、距诊断时间≤5 年且无记忆障碍的门诊 LC 患者。参与者回答了 SC-needs 和 PCC 质量问卷。我们进行了多次负二项回归分析,以评估与 SC-needs 增加相关的因素。
共有 128 名 LC 患者参与了本研究。大多数参与者患有腺癌(61.7%),且处于疾病晚期(92.1%)。在调查前一个月,3.9%的患者接受了手术,78.9%的患者接受了化疗和/或放疗;28.9%的患者有抑郁症状,21.9%的患者有焦虑症状。所有患者均报告了一种或多种 SC-needs,主要是身体、日常生活、信息和心理需求。在满足患者生物心理社会需求和治疗决策信息方面,PCC 质量存在显著差距。降低 SC-needs 可能性的因素是尊重和协调的护理、高中学历和年龄较大。增加 SC-needs 可能性的因素是 LC 类型(腺癌、间充质肿瘤)、化疗和/或放疗以及焦虑。
应优先考虑改善 PCC,以满足 LC 患者的 SC-needs,并应侧重于:(1)提供有关缓解身体痛苦和治疗的信息;(2)提供心理支持;(3)监测 SC-needs。