Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka 1000, Bangladesh.
Compassionate Narayanganj (Community-Based Palliative Care Project), c/o Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka 1000, Bangladesh.
Int J Environ Res Public Health. 2023 Jul 25;20(15):6443. doi: 10.3390/ijerph20156443.
Cancer, a leading cause of mortality worldwide, is often diagnosed at late stages in low- and middle-income countries, resulting in preventable suffering. When added to standard oncological care, palliative care may improve the quality of life (QOL) of these patients. A longitudinal observational study was conducted from January 2020 to December 2021. Thirty-nine cancer patients were enrolled in the Compassionate Narayanganj community palliative care group (NPC), where they received comprehensive palliative care in addition to oncological care. Thirty-one patients from the Dept. of Oncology (DO) at BSMMU received standard oncological care. In contrast to the DO group, the NPC group had a higher percentage of female patients, was older, and had slightly higher levels of education. At 10 to 14 weeks follow-up, a significant improvement in overall QOL was observed in the NPC group ( = 0.007), as well as in the psychological ( = 0.003), social ( = 0.002), and environmental domains ( = 0.15). Among the secondary outcomes, the palliative care group had reduced disability and neuropathic pain scores. Additionally, there were statistically significant reductions in pain, drowsiness, and shortness of breath, as well as an improvement in general wellbeing, based on the results of the Edmonton Symptom Assessment Scale-Revised. At the community level in Bangladesh, increased access to palliative care may improve cancer patient outcomes such as QOL and symptom burden.
癌症是全球主要的致死原因之一,在中低收入国家常常被诊断为晚期,导致本可预防的痛苦。在标准肿瘤治疗的基础上,姑息治疗可能会提高这些患者的生活质量(QOL)。一项纵向观察性研究于 2020 年 1 月至 2021 年 12 月进行。39 名癌症患者被纳入纳拉扬甘杰社区姑息治疗组(NPC),他们在接受肿瘤治疗的同时还接受了综合姑息治疗。BSMMU 肿瘤科(DO)的 31 名患者接受了标准肿瘤治疗。与 DO 组相比,NPC 组女性患者比例较高,年龄较大,教育程度略高。在 10 至 14 周的随访中,NPC 组的总体 QOL 有显著改善(=0.007),心理(=0.003)、社会(=0.002)和环境领域(=0.15)也有改善。在次要结局中,姑息治疗组的残疾和神经病理性疼痛评分有所降低。此外,基于 Edmonton 症状评估量表修订版的结果,疼痛、嗜睡和呼吸急促的程度也有统计学意义的降低,整体幸福感也有所提高。在孟加拉国的社区层面,增加姑息治疗的可及性可能会改善癌症患者的结局,如生活质量和症状负担。