Duke University School of Medicine (L.M.S.), Durham, North Carolina.
Department of Psychiatry and Behavior Sciences (J.H.), Department of Internal Medicine, Emory University School of Medicine, Atlanta, Georgia.
J Pain Symptom Manage. 2024 Feb;67(2):115-125. doi: 10.1016/j.jpainsymman.2023.10.013. Epub 2023 Oct 15.
Palliative Care (PC) is poorly understood by laypersons. However, little is known about what ambulatory patients with cancer understand about PC or what barriers to access exist.
Outpatients undergoing cancer treatment completed a survey evaluating their familiarity and knowledge of PC, Palliative Care Knowledge Scale (PaCKS), feelings towards PC (before and after reading a definition of PC), barriers to PC, and prognostic understanding. We summarized responses descriptively and used logistic regression models to examine variables associated with familiarity and interest.
The survey response rate was 32%. Of 151 participants, 58.9% reported familiarity with PC. The average PaCKs score was 11.9 out of 13 (standard deviation, 1.4), with 46.4% receiving a perfect score, indicating high knowledge of PC. Patients diagnosed more than one year ago had significantly increased odds of being familiar with PC (OR 2.93; 95% CI 1.37-6.25). More participants reported future interest in PC compared to current interest (74.2% vs 44.4%, respectively). Patients with stage III or IV cancer had significantly increased odds of having a current interest in receiving PC compared to patients with stage I or II disease (OR 2.66; 95% CI: 1.05, 6.76). Participants reported feeling significantly less anxious and more reassured after reading a standardized definition of PC (P < 0.05).
Outpatients with cancer who are being treated at a large academic cancer center exhibit high awareness and knowledge of PC, but anxiety toward PC persists. Factors beyond knowledge may perpetuate the delayed or lack of involvement with PC.
In this cross-sectional study of outpatients with cancer, findings suggest that high knowledge of PC may co-exist with a lingering uneasiness towards the service. Additionally, factors beyond knowledge, such as logistic barriers, anxiety, and oncologists' preference may be perpetuating the delay or lack of involvement in PC.
姑息治疗（PC）在非专业人士中理解较差。然而，对于接受癌症治疗的门诊患者对 PC 的理解程度或存在哪些获得 PC 的障碍知之甚少。
正在接受癌症治疗的门诊患者完成了一项调查，评估他们对 PC 的熟悉程度和了解程度、姑息治疗知识量表（PaCKS）、对 PC 的感受（在阅读 PC 定义之前和之后）、PC 障碍以及预后理解。我们对回答进行了描述性总结，并使用逻辑回归模型来检查与熟悉度和兴趣相关的变量。
调查的回复率为 32%。在 151 名参与者中，58.9%报告熟悉 PC。平均 PaCKs 得分为 13 分中的 11.9 分（标准差为 1.4），46.4%的人获得了满分，表明对 PC 有很高的了解。诊断超过一年的患者对 PC 熟悉的可能性显著增加（OR 2.93；95%CI 1.37-6.25）。与当前相比，更多的患者报告未来对 PC 感兴趣（分别为 74.2%和 44.4%）。与疾病 I 或 II 期患者相比，III 期或 IV 期癌症患者目前对接受 PC 的兴趣显著增加（OR 2.66；95%CI：1.05,6.76）。参与者在阅读 PC 的标准化定义后，报告的焦虑感明显减轻，感到更安心（P<0.05）。
在一家大型学术癌症中心接受治疗的癌症门诊患者对 PC 的认识和了解程度较高，但对 PC 的焦虑仍然存在。除了知识之外的因素可能会使他们延迟或缺乏对 PC 的参与。
在这项对癌症门诊患者的横断面研究中，研究结果表明，PC 知识水平较高可能与对该服务的挥之不去的不安同时存在。此外，除了知识之外的因素，如逻辑障碍、焦虑和肿瘤医生的偏好，可能会导致对 PC 的延迟或缺乏参与。
