出院小结内容的差异：肿瘤医生与家庭医生的需求。

Differences in discharge letter content: oncologists' vs. home care physicians' needs.

机构信息

Department of Palliative Medicine, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, 277-8577, Japan.

Department of Nephrology, Aso Iizuka Hospital, Iizuka, Japan.

出版信息

Support Care Cancer. 2024 Apr 22;32(5):299. doi: 10.1007/s00520-024-08507-1.

DOI:10.1007/s00520-024-08507-1

PMID:38644420

Abstract

PURPOSE

To compare the details, oncologists include in discharge letters with what home care physicians need. Although discharge letters are important to share patients' information for home palliative care, few studies have compared the details, especially patients' emotions, regarding what oncologists include in discharge letters and home care physicians' needs.

METHODS

This cross-sectional study was conducted by sending anonymous, self-administered questionnaires to 500 certified oncologists (OCs) and 500 directors of home care supporting clinics (HCs) in Japan between March and May 2023. The survey considered 20 potential items found in discharge letters, and compared rates of OCs including these items and HCs needs.

RESULTS

Of 310 valid responses, 186 were from OCs (average age: 47.7; 29 females) and 124 from HCs (average age: 55.4; 9 females). Major items with lower inclusion rates for OCs included patients' emotions regarding medical conditions (58.4% in OCs vs. 92.6% in HCs, p < 0.001), families' emotions regarding medical conditions (60.0 vs. 92.6%, respectively, p < 0.001), patients' perceptions regarding medical conditions (84.9 vs. 94.3%, respectively, p = 0.011), families' perceptions regarding medical conditions (84.3 vs. 95.1%, respectively, p = 0.004), and potential late-onset treatment-related adverse events (79.3 vs. 92.6%, respectively, p = 0.002). Conversely, OCs included patients' activities of daily living more frequently (96.2 vs. 90.2%, respectively, p = 0.031).

CONCLUSION

Transitioning to home-based palliative care may necessitate accurate information and consideration of patients' and families' perceptions and emotions regarding medical conditions in discharge letters for continuous provision of high-quality care.

摘要

目的

比较肿瘤医生在出院小结中记录的内容与家庭医疗保健医生的需求。虽然出院小结对于分享患者的信息以进行家庭姑息治疗很重要，但很少有研究比较肿瘤医生记录的内容和家庭医疗保健医生的需求，特别是患者的情绪。

方法

本研究采用横断面研究，于 2023 年 3 月至 5 月间向日本 500 名认证肿瘤医生（OC）和 500 名家庭医疗保健支持诊所主任（HC）发放匿名自填式问卷。该调查考虑了 20 项可能出现在出院小结中的项目，并比较了 OC 记录这些项目的比例和 HC 的需求。

结果

在 310 份有效回复中，186 份来自 OC（平均年龄：47.7；29 名女性），124 份来自 HC（平均年龄：55.4；9 名女性）。OC 记录率较低的主要项目包括患者对病情的情绪（OC 中为 58.4%，HC 中为 92.6%，p<0.001）、家庭对病情的情绪（OC 中为 60.0%，HC 中为 92.6%，分别为 p<0.001）、患者对病情的看法（OC 中为 84.9%，HC 中为 94.3%，p=0.011）、家庭对病情的看法（OC 中为 84.3%，HC 中为 95.1%，p=0.004）和潜在的迟发性治疗相关不良事件（OC 中为 79.3%，HC 中为 92.6%，分别为 p=0.002）。相反，OC 更频繁地记录患者的日常生活活动（OC 中为 96.2%，HC 中为 90.2%，p=0.031）。