Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinik und Poliklinik für Strahlentherapie.
Institut für Medizinische Epidemiologie, Biometrie und Informatik Universitätsmedizin Halle (Saale), Germany.
Medicine (Baltimore). 2021 Mar 26;100(12):e24320. doi: 10.1097/MD.0000000000024320.
Palliative care is a central component of the therapy in terminally ill patients. During treatment in non-palliative departments this can be realized by consultation.To analyze the change in symptom burden during palliative care consultation.In this observational study, we enrolled all cancer cases (n = 163) receiving inpatient treatment for 2015 to 2018 at our institution. We used the MDASI-questionnaire (0 = 'not present' and 10 = "as bad as you can imagine") and the FAMCARE-6 (1 = very satisfied, 5 = very dissatisfied) to analyze the treatment effect and patient satisfaction, respectively.We examined the association of symptom burden and patient satisfaction using Spearman-correlation. Comparing mean values, we applied the Wilcoxon-test and one-way ANOVA.An improvement in MDASI-core-items after treatment completion was significant (P < .05) in 14/18 symptoms. The change in perception of pain showed the strongest improvement (median: 5 to 3). Initially the MDASI-items "activity" (median = 8) and emotional distress (median = 5 and 6) were viewed as especially incriminating. There was no evidence for a correlation between patients' age, the type of diagnosis and time since diagnosis.The analysis of FAMCARE-6 patient contentment was lower or equal to two in all of the six items. There was a weak negative association between the change in symptom burden of psycho-emotional items "distress/feeling upset" (P = .006, rSp = -0,226), "sadness" and patient satisfaction in FAMCARE-6.A considerable improvement of the extensive symptom burden particularly of pain relief was achieved by integrating palliative consultation in clinical practice.
姑息治疗是终末期患者治疗的核心组成部分。在非姑息治疗科室进行治疗时,可以通过咨询来实现这一点。
分析姑息治疗咨询过程中症状负担的变化。
在这项观察性研究中,我们招募了所有在我们机构接受姑息治疗的癌症患者(n=163)。我们使用 MDASI 问卷(0=“不存在”和 10=“无法想象的严重”)和 FAMCARE-6(1=非常满意,5=非常不满意)来分析治疗效果和患者满意度。
我们使用 Spearman 相关分析来研究症状负担与患者满意度之间的关系。通过比较平均值,我们应用了 Wilcoxon 检验和单因素方差分析。
治疗完成后,MDASI 核心项目的改善具有统计学意义(P<0.05),18 项症状中的 14 项均有改善。疼痛感知的变化显示出最强的改善(中位数:5 变为 3)。最初,MDASI 项目“活动”(中位数=8)和情绪困扰(中位数=5 和 6)被认为是特别严重的问题。患者年龄、诊断类型和诊断后时间与症状负担的变化之间没有相关性。
在所有六个项目中,FAMCARE-6 患者满意度分析的结果均低于或等于 2。在心理-情感项目“痛苦/不安”(P=0.006,rSp=-0.226)和“悲伤”的症状负担变化与 FAMCARE-6 患者满意度之间存在弱负相关。
通过将姑息治疗咨询纳入临床实践,广泛的症状负担得到了显著改善,尤其是疼痛缓解。