Gynaecological Oncology, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK
University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
Int J Gynecol Cancer. 2022 Jul 4;32(7):924-930. doi: 10.1136/ijgc-2022-003396.
Frailty has been associated with worse cancer-related outcomes for people with gynecological cancers. However, the lack of clear guidance on how to assess and modify frailty prior to instigating active treatments has the potential to lead to large variations in practice and outcomes. This study aimed to evaluate current practice and perspectives of healthcare practitioners on the provision of care for patients with frailty and a gynecological cancer.
Data were collected via a questionnaire-based survey distributed by the Audit and Research in Gynecological Oncology (ARGO) collaborative to healthcare professionals who identified as working with patients with gynecological malignancies in the United Kingdom (UK) or Ireland. Study data were collected using REDCap software hosted at the University of Manchester. Responses were collected over a 16 week period between January and April 2021.
A total of 206 healthcare professionals (30 anesthetists (14.6%), 30 pre-operative nurses (14.6%), 51 surgeons (24.8%), 34 cancer specialist nurses (16.5%), 21 medical/clinical oncologists (10.2%), 25 physiotherapists/occupational therapists (12.1%) and 15 dieticians (7.3%)) completed the survey. The respondents worked at 19 hospital trusts across the UK and Ireland. Frailty scoring was not routinely performed in 63% of care settings, yet the majority of practitioners reported modifying their practice when providing and deciding on care for patients with frailty. Only 16% of organizations surveyed had a dedicated pathway for assessment and management of patients with frailty. A total of 37% of respondents reported access to prehabilitation services, 79% to enhanced recovery, and 27% to community rehabilitation teams.
Practitioners from all groups surveyed considered that appropriate training, dedicated pathways for optimization, frailty specific performance indicators and evidence that frailty scoring had an impact on clinical outcomes and patient experience could all help to improve care for frail patients.
虚弱与妇科癌症患者的癌症相关结局较差有关。然而，在开始积极治疗之前，缺乏明确的评估和调整虚弱的指导，有可能导致实践和结果的巨大差异。本研究旨在评估医疗保健从业者在为虚弱和妇科癌症患者提供护理方面的当前实践和观点。
通过 ARGO 协作组织向在英国或爱尔兰为妇科恶性肿瘤患者提供服务的医疗保健专业人员分发基于问卷的调查收集数据。该研究数据使用托管在曼彻斯特大学的 REDCap 软件进行收集。答复在 2021 年 1 月至 4 月的 16 周内收集。
共有 206 名医疗保健专业人员（30 名麻醉师（14.6％），30 名术前护士（14.6％），51 名外科医生（24.8％），34 名癌症专科护士（16.5％），21 名医学/临床肿瘤学家（10.2％），25 名物理治疗师/职业治疗师（12.1％）和 15 名营养师（7.3％））完成了调查。受访者在英国和爱尔兰的 19 家医院信托工作。在 63％的护理环境中没有常规进行虚弱评分，但大多数从业者在为虚弱患者提供护理和决定护理时报告了调整其做法。只有 16％的被调查组织有专门的评估和管理虚弱患者的途径。总共 37％的受访者报告有机会获得康复前服务，79％有机会获得强化康复，27％有机会获得社区康复团队。
所有接受调查的小组的从业者都认为适当的培训、优化的专用途径、虚弱特定的绩效指标以及虚弱评分对临床结果和患者体验有影响的证据，都可以帮助改善对虚弱患者的护理。
