Institute for Palliative Care, Lund University and Region Skåne, Lund, Sweden.
Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
PLoS One. 2023 Jun 22;18(6):e0287550. doi: 10.1371/journal.pone.0287550. eCollection 2023.
Integration of oncology and palliative care has been shown to increase quality of life in advanced disease. To meet the needs of the growing older population, integration of palliative care and geriatrics has been proposed but scarcely described.
The aim of this study was to integrate palliative care into geriatrics by a structured care guide, the Swedish Palliative Care Guide, and to evaluate its effect on patient satisfaction, health-related quality of life and symptom burden, compared to a control group.
Geriatric in-patients over 65 years of age were included in the study, those with cognitive impairment were excluded. Data was collected before (baseline) and after the implementation (intervention) of the Swedish Palliative Care Guide. Patient satisfaction was evaluated two weeks after discharge with questions from a national patient survey. Health-related quality of life was measured with EQ-5D-3L and symptom burden with Edmonton Symptom Assessment Scale.
In total, 400 patients were included, 200 in the baseline- and intervention group, respectively. Mean age was 83 years in both groups. Patient satisfaction was significantly higher in nine out of ten questions (p = 0.02-<0.001) in the intervention group compared to baseline. No differences between the groups were seen in health-related quality of life or symptom burden.
A significant effect on patient satisfaction was seen after implementation of the Swedish Palliative Care Guide in geriatric care. Thus, integration of palliative care and geriatrics could be of substantial benefit in the growing population of older adults with multimorbidity and frailty.
肿瘤学和姑息治疗的整合已被证明可以提高晚期疾病的生活质量。为了满足不断增长的老年人口的需求，已经提出了姑息治疗与老年医学的整合，但几乎没有描述。
本研究的目的是通过结构化的护理指南，即瑞典姑息护理指南，将姑息治疗整合到老年医学中，并评估其与对照组相比对患者满意度、健康相关生活质量和症状负担的影响。
本研究纳入了 65 岁以上的老年住院患者，排除了有认知障碍的患者。在实施（干预）瑞典姑息护理指南之前（基线）和之后收集数据。在出院后两周，通过全国性的患者调查，使用问题评估患者满意度。使用 EQ-5D-3L 评估健康相关生活质量，使用 Edmonton 症状评估量表评估症状负担。
共纳入 400 名患者，分别为基线组和干预组各 200 名。两组患者的平均年龄均为 83 岁。与基线相比，干预组在十个问题中的九个问题（p = 0.02-<0.001）中患者满意度显著更高。两组在健康相关生活质量或症状负担方面没有差异。
在老年医学中实施瑞典姑息护理指南后，患者满意度有显著影响。因此，姑息治疗与老年医学的整合可能对患有多种合并症和衰弱的老年人口有很大的益处。
