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德国的住院临终关怀机构:肿瘤患者的医疗护理状况及用于症状控制的支持性肿瘤治疗方法的使用情况

Inpatient Hospices in Germany: Medical Care Situation and Use of Supportive Oncological Therapies for Symptom Control in Tumor Patients.

作者信息

Kaiser Ulrich, Vehling-Kaiser Ursula, Hoffmann Ana, Kaiser Florian

机构信息

Clinic and Polyclinic for Internal Medicine III, University Hospital Regensburg, Regensburg, Germany.

Oncology/Palliative Care Network Landshut, Landshut, Germany.

出版信息

Palliat Med Rep. 2022 Aug 18;3(1):169-180. doi: 10.1089/pmr.2022.0026. eCollection 2022.

Abstract

BACKGROUND

More than 80% of the residents in German hospices suffer from tumor disease. But the administration of supportive-oncological therapies in hospices for symptom control is controversially discussed.

OBJECTIVES

This study aims to investigate the care situation of tumor patients in German hospices with regard to medical care and the use of supportive-oncological therapies.

METHODS

In February 2019, all hospices in Germany were offered the opportunity to participate in an anonymous online survey on medical and drug care for their tumor patients. The survey was conducted using the online platform SoSci Survey and ended in April 2019. The analysis was descriptive.

RESULTS

Of 202 hospices, 112 responded to the questionnaire. The hospices were distributed nationwide. Most have 8 to 10 places. More than 80% of hospice residents are tumor patients, and the length of stay is usually three to four weeks. Medical care is primarily provided by primary care physicians. While specialized outpatient palliative care is increasingly involved in care, hematologists/oncologists are rarely represented. Supportive-oncological therapies are rarely prescribed, whereas medication for other chronic conditions is often continued. The percentage of supportive-oncological therapies prescribed is higher in hospices with oncology co-care.

CONCLUSIONS

Although most hospice residents suffer from malignant disease, co-care by a hematologist/oncologist is rare. Supportive-oncology therapies, particularly for symptom relief, may therefore be rarely used. However, since a small select group of hospice residents may benefit from these therapies, further investigation in this direction should be undertaken.

摘要

背景

德国临终关怀机构中超过80%的居民患有肿瘤疾病。但对于在临终关怀机构中使用支持性肿瘤治疗以控制症状,目前存在争议。

目的

本研究旨在调查德国临终关怀机构中肿瘤患者在医疗护理和支持性肿瘤治疗使用方面的护理情况。

方法

2019年2月,德国所有临终关怀机构都有机会参与一项关于其肿瘤患者医疗和药物护理的匿名在线调查。该调查使用在线平台SoSci Survey进行,于2019年4月结束。分析采用描述性方法。

结果

在202家临终关怀机构中,112家回复了问卷。这些临终关怀机构分布在全国。大多数机构有8至10个床位。超过80%的临终关怀机构居民是肿瘤患者,住院时间通常为三至四周。医疗护理主要由初级保健医生提供。虽然专门的门诊姑息治疗越来越多地参与护理,但血液科医生/肿瘤内科医生很少参与。支持性肿瘤治疗很少被处方,而其他慢性病的药物治疗通常会继续。在有肿瘤联合护理的临终关怀机构中,支持性肿瘤治疗的处方百分比更高。

结论

尽管大多数临终关怀机构居民患有恶性疾病,但血液科医生/肿瘤内科医生的联合护理很少见。因此,支持性肿瘤治疗,特别是用于缓解症状的治疗,可能很少被使用。然而,由于一小部分临终关怀机构居民可能从这些治疗中受益,应在这个方向上进行进一步调查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49bd/9438444/bfff9010f2f5/pmr.2022.0026_figure1.jpg

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