Senior Cancer Research Nurse, North Bristol NHS Trust, Bristol.
Associate Professor of Cancer Nursing, School of Health and Social Care, Edinburgh Napier University, Edinburgh.
Br J Nurs. 2023 Mar 9;32(5):S10-S14. doi: 10.12968/bjon.2023.32.5.S10.
New treatment options have significantly improved the life expectancy of myeloma patients such that their cause of death is increasingly likely to be from something other than myeloma. Furthermore, the adverse effects of short- or long-term treatments as well as the disease are impacting on quality of life (QoL) for longer periods of time. Understanding people's QoL and what is important to them, is part of providing holistic care. Although QoL data has been collected for many years in myeloma studies, they have not been used to inform patient outcomes. There is growing evidence that supports the assessment of 'fitness' and consideration of QoL as part of routine myeloma care. A national survey was carried out to discover which QoL tools are currently being used in the routine care of myeloma patients, by whom and at which time point.
An online survey using SurveyMonkey was adopted for flexibility and accessibility. The link to the survey was circulated via Bloodwise, Myeloma UK and Cancer Research UK contact lists. Paper questionnaires were circulated at the UK Myeloma Forum.
Data about practices in 26 centres were collected. This included sites across England and Wales. Three out of 26 centres collect QoL data as part of standard care. QoL tools used include EORTC QLQ-My20/24, MyPOS, FACT-BMT and Quality of Life Index. Questionnaires were completed by patients before, during or after a clinic appointment. Clinical nurse specialists calculate the scores and create a care plan.
Despite growing evidence to support an holistic approach to management of myeloma patients, there is a lack of evidence to confirm that health-related QoL is being addressed in standard care. This is an area that needs further research.
新的治疗选择显著提高了骨髓瘤患者的预期寿命,因此他们的死亡原因越来越可能不是骨髓瘤。此外,短期或长期治疗的不良反应以及疾病都在更长时间内影响生活质量(QoL)。了解人们的 QoL 以及对他们重要的是什么,是提供全面护理的一部分。尽管骨髓瘤研究已经多年来收集了 QoL 数据,但它们并未用于告知患者的结局。越来越多的证据支持将“健康状况”评估和考虑 QoL 作为常规骨髓瘤护理的一部分。进行了一项全国性调查,以了解目前在骨髓瘤患者的常规护理中使用哪些 QoL 工具、由谁使用以及在何时使用。
采用 SurveyMonkey 在线调查以实现灵活性和可访问性。该调查链接通过 Bloodwise、Myeloma UK 和 Cancer Research UK 联系列表进行分发。纸质问卷在英国骨髓瘤论坛上分发。
共收集了 26 个中心的实践数据。这些中心分布在英格兰和威尔士各地。26 个中心中有 3 个将 QoL 数据作为标准护理的一部分进行收集。使用的 QoL 工具包括 EORTC QLQ-My20/24、MyPOS、FACT-BMT 和 Quality of Life Index。问卷由患者在就诊前、就诊期间或就诊后完成。临床护士专家计算分数并制定护理计划。
尽管越来越多的证据支持对骨髓瘤患者进行整体管理方法,但缺乏证据证实标准护理中正在解决与健康相关的 QoL 问题。这是一个需要进一步研究的领域。