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为异基因干细胞移植患者开发支持性和姑息治疗干预措施:一项多中心混合方法研究(allo-PaS)方案。

Developing a supportive and palliative care intervention for patients with allogeneic stem cell transplantation: protocol of a multicentre mixed-methods study (allo-PaS).

机构信息

Department of Palliative Medicine, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany

Centre for Integrated Oncology Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.

出版信息

BMJ Open. 2023 Aug 31;13(8):e066948. doi: 10.1136/bmjopen-2022-066948.

Abstract

INTRODUCTION

Although allogeneic stem cell transplantation (allo-SCT) is a curative treatment for many haematological malignancies, it is often associated with a high morbidity and mortality. Yet, little is known about the needs for supportive and palliative care among allo-SCT recipients. Moreover, targeted interventions that reduce symptom burden and suffering are still lacking. The present study aims to inform a supportive-palliative care intervention for patients with allo-SCT and their informal carers by exploring their experience and assessing their needs, especially their existential concerns, regarding four research topics: symptom burden and quality of life; coexistence of a chance for cure and a relevant risk of dying; change in goals of care; dying phase.

METHODS AND ANALYSIS

This is a descriptive mixed-methods study in progress with a convergent parallel design. Data on the four research topics will be collected and analysed separately in three steps: (1) qualitative semi-structured interviews among 20 patients, 20 informal carers and 12 healthcare providers (HCPs) and focus groups among 12-24 HCPs; (2) a quantitative cross-sectional survey with validated questionnaires and self-developed questions among 100 patients, 100 informal carers and 50 HCPs; (3) a retrospective case analysis of all deceased patients who underwent an allo-SCT between 2010 and 2019, with collection of quantitative and qualitative data. The qualitative and quantitative data sets will be finally merged for comparison and interpretation. Results will serve to develop a supportive-palliative care intervention.

ETHICS AND DISSEMINATION

The Ethics Commission of the Faculty of Medicine of the University of Cologne approved this study (20-1370_2). The study results will be published in peer-review journals, be presented at congresses and will be translated into clinical practice through the development of the palliative-supportive care intervention.

TRIAL REGISTRATION NUMBER

DRKS00027290 (German Clinical Trials Register).

摘要

简介

虽然异基因造血干细胞移植(allo-SCT)是许多血液系统恶性肿瘤的一种根治性治疗方法,但它通常与高发病率和死亡率相关。然而,人们对 allo-SCT 受者的支持性和姑息性护理需求知之甚少。此外,仍然缺乏能够减轻症状负担和痛苦的靶向干预措施。本研究旨在通过探讨患者及其非专业照护者的经历并评估他们的需求,特别是他们对四个研究主题的生存问题的关注,为 allo-SCT 患者及其非专业照护者提供一种支持性姑息护理干预措施。这四个研究主题包括:症状负担和生活质量;治愈机会与相关死亡风险共存;治疗目标变化;临终阶段。

方法和分析

这是一项正在进行的描述性混合方法研究,采用汇聚平行设计。将分三个步骤分别收集和分析四个研究主题的数据:(1)对 20 名患者、20 名非专业照护者和 12 名医疗保健提供者(HCP)进行半结构式定性访谈,并对 12-24 名 HCP 进行焦点小组讨论;(2)对 100 名患者、100 名非专业照护者和 50 名 HCP 进行横断面问卷调查,使用经过验证的问卷和自行开发的问题;(3)对 2010 年至 2019 年间接受 allo-SCT 的所有已故患者进行回顾性病例分析,收集定量和定性数据。最后,将定性和定量数据集合并进行比较和解释。研究结果将用于开发一种支持性姑息护理干预措施。

伦理和传播

科隆大学医学院伦理委员会批准了这项研究(20-1370_2)。研究结果将发表在同行评议期刊上,在会议上展示,并通过开发姑息支持性护理干预措施转化为临床实践。

试验注册号

DRKS00027290(德国临床试验注册)。

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