Caminiti Caterina, Diodati Francesca, Annunziata Maria Antonietta, Di Giulio Paola, Isa Luciano, Mosconi Paola, Nanni Maria Giulia, Patrini Adele, Piredda Michela, Santangelo Claudia, Verusio Claudio, Cinquini Michela, Fittipaldo Veronica Andrea, Passalacqua Rodolfo
Clinical and Epidemiology Research Unit, University Hospital of Parma, 43126 Parma, Italy.
Oncological Psychology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy.
Cancers (Basel). 2021 Sep 29;13(19):4878. doi: 10.3390/cancers13194878.
Psychosocial morbidity can have negative consequences for cancer patients, including maladaptive coping, poor treatment adherence, and lower quality of life. Evidence shows that psychosocial interventions can positively impact quality of life, as well as symptoms and side effects; however, they are not always offered to patients who might benefit from them. These guidelines were produced by a multidisciplinary panel of 16 experts, including patients, following GRADE methodology. The panel framed clinical questions and voted on outcomes to investigate. Studies identified by rigorous search strategies were assessed to rate certainty of evidence, and recommendations were formulated by the panel. Although the quality of the evidence found was generally moderate, interventions could be recommended aimed at improving patient information, communication with healthcare professionals and involvement in decision-making; detecting and managing patient psychosocial needs, particularly with non-pharmacological therapy; and supporting families of patients with advanced cancer. The role of nurses as providers of information and psychosocial care is stressed. Most recommended interventions do not appear to necessitate new services or infrastructures, and therefore do not require allocation of additional resources, but predominantly involve changes in clinical staff behavior and/or ward organization. Patients should be made aware of psychosocial care standards so that they can expect to receive them.
心理社会问题可能会给癌症患者带来负面后果,包括适应不良的应对方式、较差的治疗依从性以及较低的生活质量。有证据表明,心理社会干预可以对生活质量以及症状和副作用产生积极影响;然而,对于可能从中受益的患者,这些干预措施并非总是能提供给他们。这些指南由包括患者在内的16名专家组成的多学科小组按照GRADE方法制定。该小组提出了临床问题并对要调查的结果进行投票。对通过严格检索策略确定的研究进行评估,以评定证据的确定性,然后由该小组制定建议。尽管所发现证据的质量总体上为中等,但可以推荐一些干预措施,旨在改善患者信息、与医疗保健专业人员的沟通以及参与决策;检测和管理患者的心理社会需求,特别是通过非药物治疗;以及支持晚期癌症患者的家属。强调了护士作为信息提供者和心理社会护理者的作用。大多数推荐的干预措施似乎并不需要新的服务或基础设施,因此不需要分配额外资源,主要涉及临床工作人员行为和/或病房组织的改变。应该让患者了解心理社会护理标准,以便他们能够期望获得这些服务。