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对接受骨髓移植的血液系统恶性肿瘤患者早期姑息治疗干预措施的认知与误解

Perceptions and Misperceptions of Early Palliative Care Interventions for Patients With Hematologic Malignancies Undergoing Bone Marrow Transplantation.

作者信息

Suthumphong Corey, Tran Dan B, Ruiz Marco

机构信息

Translational Medicine, Florida International University, Herbert Wertheim College of Medicine, Miami, USA.

Miami Cancer Institute, Baptist Health South Florida, Miami, USA.

出版信息

Cureus. 2021 Mar 14;13(3):e13876. doi: 10.7759/cureus.13876.

Abstract

Hematopoietic stem cell or bone marrow transplantation (BMT) is one of the most promising and potentially curative therapeutic options available for eligible patients with hematologic malignancies (HMs) or leukemias. However, the nature and clinical course of HMs, specifically for patients undergoing BMT, are associated with significant morbidity, symptomatology, healthcare service utilization, psychosocial and end of life issues, and overall decreased quality of life. Early palliative care (PC) consultations and utilization for patients with HMs have been shown to improve patient outcomes, satisfaction, and autonomy as well as caregiver burden, shared-decision making, and holistic care management. Despite the complexity of care and complications for patients with HM undergoing BMT, early PC interventions are systematically underutilized and understudied in this population compared to patients with solid tumors or non-HMs. Herein, the authors reviewed the current literature and knowledge to assess and report the perceptions and barriers to early PC utilization in the care of patients with HMs undergoing BMT. Clinical and cultural aspects of PC perceptions as well as current PC care models and potential directions for PC implementation were reviewed to inform future research studies and clinical practice guidelines necessary for the improvement of care and quality of life for HM patients undergoing BMT.

摘要

造血干细胞或骨髓移植(BMT)是符合条件的血液系统恶性肿瘤(HM)或白血病患者最有前景且可能治愈的治疗选择之一。然而,HM的性质和临床病程,特别是对于接受BMT的患者,与显著的发病率、症状、医疗服务利用、心理社会和生命末期问题以及总体生活质量下降相关。已证明,对HM患者进行早期姑息治疗(PC)咨询和利用可改善患者预后、满意度和自主性,减轻照护者负担,促进共同决策和整体照护管理。尽管接受BMT的HM患者的护理复杂且存在并发症,但与实体瘤患者或非HM患者相比,该人群中早期PC干预措施的系统利用率较低且研究不足。在此,作者回顾了当前的文献和知识,以评估和报告在接受BMT的HM患者护理中早期PC利用的认知和障碍。回顾了PC认知的临床和文化方面以及当前的PC护理模式和PC实施的潜在方向,以为未来的研究以及改善接受BMT的HM患者护理和生活质量所需的临床实践指南提供参考。

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