Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cancer. 2021 Jun 15;127(12):2139-2147. doi: 10.1002/cncr.33474. Epub 2021 Mar 4.
Palliative care (PC) education and research are essential to developing a skilled workforce and evidence base to support the delivery of quality cancer care. The current state of PC education and research at US cancer centers is unclear. In this national survey, the education and research programs of the National Cancer Institute (NCI)-designated and nondesignated cancer centers and the changes between 2009 and 2018 are compared.
Between April and August 2018, PC program leaders at all NCI-designated cancer centers and a random sample of nondesignated centers were sent a survey to examine the structure, processes, and outcomes of their programs on the basis of questions from a 2009 national survey. This preplanned analysis focused on education and research.
There were 52 of 61 (85%) NCI-designated and 27 of 38 (71%) nondesignated cancer centers that responded. NCI-designated centers were more likely than nondesignated centers to have a PC fellowship program (87% vs 30%; P < .001), training for advanced practice providers (71% vs 44%; P = .03), PC research program (58% vs 15%; P < .001), peer-reviewed funding (43% vs 11%; P = .005), and philanthropic grants (41% vs 7%; P = .002). There were few significant improvements in PC education or research between 2009 and 2018 for both groups, notable exceptions include an increase in PC fellowships (38% vs 87%; P < .001) and mandatory PC rotations for medical oncology fellows (29% vs 55%; P = .02) at NCI-designated cancer centers.
PC education and research are more developed at NCI-designated cancer centers. Despite some progress over the past decade, it is relatively slow and suboptimal.
姑息治疗(PC)教育和研究对于培养熟练的劳动力和提供支持高质量癌症护理的证据基础至关重要。目前美国癌症中心的 PC 教育和研究现状尚不清楚。在这项全国性调查中,对美国国立癌症研究所(NCI)指定和非指定癌症中心的教育和研究计划以及 2009 年至 2018 年期间的变化进行了比较。
2018 年 4 月至 8 月,向所有 NCI 指定癌症中心和随机抽取的非指定癌症中心的 PC 项目负责人发送了一份调查,根据 2009 年全国调查的问题,调查他们项目的结构、过程和结果。本次预先计划的分析重点是教育和研究。
共有 61 个 NCI 指定癌症中心中的 52 个(85%)和 38 个非指定癌症中心中的 27 个(71%)做出回应。NCI 指定中心比非指定中心更有可能拥有 PC 研究员项目(87%比 30%;P <.001)、为高级实践提供培训(71%比 44%;P =.03)、PC 研究项目(58%比 15%;P <.001)、同行评议的资助(43%比 11%;P =.005)和慈善赠款(41%比 7%;P =.002)。NCI 指定癌症中心在 2009 年至 2018 年期间,PC 教育或研究方面几乎没有明显的改善,只有一些显著的例外,包括 PC 研究员项目增加(38%比 87%;P <.001)和对肿瘤内科研究员强制进行 PC 轮岗(29%比 55%;P =.02)。
NCI 指定癌症中心的 PC 教育和研究更为发达。尽管过去十年取得了一些进展,但进展相对缓慢且不理想。