Sousa Beatriz R, Dias Moreira Teresa, Pires Pedro
Internal Medicine, Centro Hospitalar Universitário de Lisboa Central, Lisbon, PRT.
Palliative Care, Instituto Português de Oncologia do Porto Francisco Gentil, Oporto, PRT.
Cureus. 2023 Apr 21;15(4):e37930. doi: 10.7759/cureus.37930. eCollection 2023 Apr.
Introduction The goal of palliative care (PC) is to improve the quality of life of patients and their families through the involvement of a multidisciplinary team. PC improves symptom control and end-of-life care. Despite the fact that the benefits of PC have long been acknowledged, Portugal's demands are currently unmet. The majority of patients have been identified as having a high level of complexity and are referred for symptom management and end-of-life care. Study aim The study aimed to analyze the sociodemographic, disease and hospitalization characteristics of the patients admitted to a specialized PC unit. Materials and methods We conducted a retrospective, single-center study of palliative care patients admitted to a Portuguese oncology institute's acute palliative care unit during a three-month period. Patients' information such as social demographics, clinical data, patient and family member's psychological, social, nutritional and spiritual counseling and knowledge on diagnosis and therapy objectives were collected from physician's records and analyzed using SPSS Statistics for Windows, Version 23.0 (IBM SPSS Statistics for Windows). Results A total of 41 patients were included, with a mean age of 66.4 years. Spouses were the primary caregivers. There was no indication for targeted therapy in any of the patients. Prior to hospitalization, 58.5% did not receive follow-up by PC. The most frequently reported symptoms were pain (75.6%), tiredness (68.3%), anorexia (61%) and emotional distress (58.5%). Patients were referred to counseling for psychological (43.3%), spiritual (19.5%), nutritional (58.5%) and social services (34.1%). During hospitalization, 75% of patients died; out of which, 70.9% were not previously followed up on by the PC team. Conclusion PC patients are complex, with multiple clinical-psychological-social-spiritual issues, and their management in non-PC wards can be challenging. Since the use of a multidisciplinary approach can improve patients' and families' quality of life, it is critical to train, expand and integrate the PC teams into the existing teams, allowing patients a better quality of life until they pass.
引言 姑息治疗（PC）的目标是通过多学科团队的参与来提高患者及其家属的生活质量。姑息治疗可改善症状控制和临终关怀。尽管姑息治疗的益处早已得到认可，但葡萄牙目前对其的需求仍未得到满足。大多数患者被认定为具有高度复杂性，并被转介接受症状管理和临终关怀。
研究目的 本研究旨在分析入住专门姑息治疗病房的患者的社会人口学、疾病及住院特征。
材料与方法 我们对一家葡萄牙肿瘤研究所急性姑息治疗病房在三个月期间收治的姑息治疗患者进行了一项回顾性单中心研究。从医生记录中收集患者的社会人口学信息、临床数据、患者及家属的心理、社会、营养和精神咨询情况以及对诊断和治疗目标的了解情况，并使用Windows版SPSS Statistics 23.0（IBM SPSS Statistics for Windows）进行分析。
结果 共纳入41例患者，平均年龄66.4岁。配偶是主要照顾者。所有患者均无靶向治疗指征。住院前，58.5%的患者未接受姑息治疗随访。最常报告的症状为疼痛（75.6%）、疲劳（68.3%）、厌食（61%）和情绪困扰（58.5%）。患者被转介接受心理（43.3%）、精神（19.5%）、营养（58.5%）和社会服务（34.1%）咨询。住院期间，75%的患者死亡；其中，70.9%的患者此前未接受姑息治疗团队的随访。
结论 姑息治疗患者情况复杂，存在多种临床 - 心理 - 社会 - 精神问题，在非姑息治疗病房对其进行管理具有挑战性。由于采用多学科方法可提高患者及其家属的生活质量，因此培训、扩大姑息治疗团队并将其融入现有团队至关重要，这样可让患者在离世前享有更好的生活质量。
