University of Technology Sydney, Sydney, NSW, Australia.
IMPACCT (Improving Palliative, Aged and Chronic Care Through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia.
Support Care Cancer. 2023 Jul 3;31(7):436. doi: 10.1007/s00520-023-07889-y.
PURPOSE: This study asked consumers (patients, carers) and healthcare professionals (HCPs) to identify the most important symptoms for adults with cancer and potential treatment interventions. METHODS: A modified Delphi study was conducted involving two rounds of electronic surveys based on prevalent cancer symptoms identified from the literature. Round 1 gathered information on participant demographics, opinions and/or experience on cancer symptom frequency and impact, and suggestions for interventions and/or service delivery models for further research to improve management of cancer symptoms. In Round 2, respondents ranked the importance of the top ten interventions identified in Round 1. In Round 3, separate expert panels of consumers and healthcare professionals (HCPs) attempted to reach consensus on the symptoms and interventions previously identified. RESULTS: Consensus was reached for six symptoms across both groups: fatigue, constipation, diarrhoea, incontinence, and difficulty with urination. Notably, fatigue was the only symptom to reach consensus across both groups in Round 1. Similarly, consensus was reached for six interventions across both groups. These were the following: medicinal cannabis, physical activity, psychological therapies, non-opioid interventions for pain, opioids for breathlessness and cough, and other pharmacological interventions. CONCLUSIONS: Consumers and HCPs prioritise differently; however, the symptoms and interventions that reached consensus provide a basis for future research. Fatigue should be considered a high priority given its prevalence and its influence on other symptoms. The lack of consumer consensus indicates the uniqueness of their experience and the need for a patient-centred approach. Understanding individual consumer experience is important when planning research into better symptom management.
目的:本研究旨在让消费者(患者、照护者)和医疗保健专业人员(HCP)识别出成人癌症患者最重要的症状和潜在的治疗干预措施。
方法:采用改良 Delphi 法,进行了两轮基于文献中确定的常见癌症症状的电子调查。第一轮收集了参与者的人口统计学信息、对癌症症状频率和影响的意见和/或经验,以及对进一步研究改善癌症症状管理的干预措施和/或服务提供模式的建议。在第二轮中,受访者对第一轮中确定的前 10 项干预措施的重要性进行了排名。在第三轮中,消费者和医疗保健专业人员(HCP)的独立专家小组试图就之前确定的症状和干预措施达成共识。
结果:两组均对六个症状达成共识:疲劳、便秘、腹泻、尿失禁和排尿困难。值得注意的是,疲劳是第一轮中唯一在两组中都达成共识的症状。同样,两组对六个干预措施也达成了共识。这些干预措施包括:医用大麻、身体活动、心理疗法、非阿片类药物干预疼痛、阿片类药物治疗呼吸困难和咳嗽以及其他药物干预。
结论:消费者和 HCP 的侧重点不同;但是,达成共识的症状和干预措施为未来的研究提供了基础。鉴于疲劳的普遍性及其对其他症状的影响,应将其视为高度优先事项。缺乏消费者共识表明他们的体验具有独特性,需要采取以患者为中心的方法。在规划改善症状管理的研究时,了解个体消费者的体验非常重要。
Cochrane Database Syst Rev. 2020-6-2
BMC Health Serv Res. 2017-7-18
Cancer Causes Control. 2025-3-4
Support Care Cancer. 2023-12-5
Curr Treat Options Oncol. 2022-7
Cancers (Basel). 2022-3-28
J Res Nurs. 2020-12
Aust J Gen Pract. 2021-8
Health Expect. 2021-8
Int J Nurs Stud. 2020-11
Curr Treat Options Oncol. 2020-2-5
CA Cancer J Clin. 2020-1-16