Division of Supportive Care and Translational Research Group, Institute for Cancer Control, National Cancer Center, Tokyo, Japan.
Tokyo Medical and Dental University, Tokyo, Japan.
Palliat Support Care. 2022 Aug;20(4):564-569. doi: 10.1017/S1478951521001796.
Early integration of palliative and cancer care improves the quality of life and is facilitated by discussions about the end of life after cessation of active cancer treatment between patients with advanced cancer and their physicians. However, both patients and physicians find end-of-life discussions challenging. The aim of this study was to assess the need for a question prompt list (QPL) that encourages end-of-life discussions between patients with advanced cancer and their physicians.
Focus group interviews (FGIs) were conducted with 18 participants comprising 5 pancreatic cancer patients, 3 family caregivers, 4 bereaved family members, and 6 physicians. Three themes were discussed: question items that should be included in the QPL that encourages end-of-life discussions with patients, family caregivers, and physicians after cessation of active cancer treatment; when the QPL should be provided; and who should provide the QPL. Each interview was audio-recorded, and content analysis was performed.
The following 9 categories, with 57 question items, emerged from the FGIs: (1) preparing for the end of life, (2) treatment decision-making, (3) current and future quality of life, (4) current and future symptom management, (5) information on the transition to palliative care services, (6) coping with cancer, (7) caregivers' role, (8) psychological care, and (9) continuity of cancer care. Participants felt that the physician in charge of the patient's care and other medical staff should provide the QPL early during active cancer treatment.
Data were collected to develop a QPL that encourages end-of-life discussions between patients with advanced cancer and their physicians.
晚期癌症患者与医生之间尽早进行姑息治疗和癌症治疗的整合，可以提高生活质量，并有助于在停止积极的癌症治疗后讨论生命末期的问题。然而，患者和医生都发现生命末期的讨论具有挑战性。本研究旨在评估是否需要一个问题提示清单（QPL）来鼓励晚期癌症患者与他们的医生进行生命末期的讨论。
对 18 名参与者进行了焦点小组访谈（FGI），参与者包括 5 名胰腺癌患者、3 名家庭照顾者、4 名丧亲家庭成员和 6 名医生。讨论了三个主题：鼓励停止积极癌症治疗后与患者、家庭照顾者和医生进行生命末期讨论的 QPL 中应包含的问题项目；应何时提供 QPL；以及应由谁提供 QPL。每次访谈均进行了录音，并进行了内容分析。
从 FGI 中得出了以下 9 个类别，共 57 个问题项目：（1）为生命末期做准备，（2）治疗决策，（3）当前和未来的生活质量，（4）当前和未来的症状管理，（5）过渡到姑息治疗服务的信息，（6）应对癌症，（7）照顾者的角色，（8）心理护理，（9）癌症治疗的连续性。参与者认为负责患者护理的医生和其他医务人员应在积极的癌症治疗期间尽早提供 QPL。
收集数据是为了开发一个问题提示清单，以鼓励晚期癌症患者与他们的医生进行生命末期的讨论。
