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头颈部癌症手术治疗患者的需求评估-一项随机对照试验。

Needs assessment in patients surgically treated for head and neck cancer-a randomized controlled trial.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.

Faculty of Health and Social Care, Edge Hill University, Ormskirk, L39 4QP and Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, Great Britain, UK.

出版信息

Support Care Cancer. 2022 May;30(5):4201-4218. doi: 10.1007/s00520-021-06759-9. Epub 2022 Jan 27.

Abstract

PURPOSE

To investigate the effect and feasibility of a head and neck cancer-specific needs assessment tool integrated into nursing rehabilitation consultations early in the post-surgical period on quality of life, symptom burden, and referrals for multidisciplinary follow-up.

METHODS

Ninety-two surgically treated patients with head and neck cancer were enrolled in a two-arm randomized controlled trial. All participants received nursing rehabilitation consultations prior to discharge, and two weeks and two months post-operative. The intervention group had their needs assessed using Patient Concerns Inventory, while standard care used a systematic questioning approach. Primary outcome was quality of life. Secondary outcomes were symptom burden and referrals for multidisciplinary rehabilitation follow-up.

RESULTS

No significant differences were found in quality of life or symptom burden between groups. However, 35% more patients in the intervention group were referred for rehabilitation. The attrition rate was similar in both groups, with a dropout rate of six in each group. No patients declined using the Patient Concerns Inventory.

CONCLUSION

The intervention showed no improvement in QoL or symptom burden compared to standard care. However, the results suggest that important needs were identified and addressed. Especially emotional and existential needs, which were accommodated through referrals and professional advice. Nursing rehabilitation consultations using the Patient Concerns Inventory are feasible and may ensure that patient preferences and priorities are incorporated in their care.

TRIAL REGISTRATION

ClinicalTrials.com (NCT03443258). Date of registration: May 31, 2018.

摘要

目的

调查在术后早期将头颈癌特定需求评估工具整合到护理康复咨询中对生活质量、症状负担和多学科随访转介的效果和可行性。

方法

92 名接受头颈癌手术治疗的患者参与了一项双臂随机对照试验。所有参与者在出院前、术后 2 周和 2 个月接受护理康复咨询。干预组使用患者关注量表进行需求评估,而标准护理则采用系统提问方法。主要结局为生活质量。次要结局为症状负担和多学科康复随访转介。

结果

两组在生活质量或症状负担方面均无显著差异。然而,干预组中有 35%的患者更多地被转介进行康复。两组的失访率相似,每组均有 6 人退出。没有患者拒绝使用患者关注量表。

结论

与标准护理相比,该干预措施并未改善 QoL 或症状负担。然而,结果表明,重要的需求得到了识别和处理。特别是情感和存在需求,通过转介和专业建议得到了满足。使用患者关注量表进行护理康复咨询是可行的,并可以确保将患者的偏好和优先事项纳入其护理中。

试验注册

ClinicalTrials.com(NCT03443258)。注册日期:2018 年 5 月 31 日。

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