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癌症患者姑息治疗的复杂性分析

Analysis of the Complexity of Palliative Care for Cancer Patients.

作者信息

Mocha Campillo Fátima, Comín Orce Ana María, Monreal Cepero María Luna, Trincado Cobos Pablo, Gómez Mugarza Pablo, Barriendos Sanz Susana, Pascual de la Fuente Natalia, Ruffini Egea Sofia, Martínez Trufero Javier

机构信息

Department of Medical Oncology, Miguel Servet University Hospital, Zaragoza, Spain.

出版信息

Am J Hosp Palliat Care. 2025 Feb;42(2):178-185. doi: 10.1177/10499091241247169. Epub 2024 Apr 25.

Abstract

INTRODUCTION

The Spanish National Health System has defined complexity as a set of factors of increased difficulty that require the intervention of a palliative care team Palliative care aims to improve the quality of life of patients with chronic terminal illnesses. This study aims to describe the degree of complexity of cancer patients in palliative care, to determine which elements of complexity are most prevalent and to determine which other hospital clinical factors are associated with the level of complexity.

METHODS

This study is a descriptive, observational, and cross-sectional analysis that included patients diagnosed with advanced oncological pathology undergoing palliative treatment who were admitted to the Medical Oncology ward of the Miguel Servet University Hospital between March and April 2023.

RESULT

A total of 100 patients were selected for the study. According to the IDC-Pal, 68% of patients were classified as highly complex, 26% of patients were complex and only 6% of patients were classified as non-complex. The presence of pain ( < .001), nausea and vomiting ( = .027), depression ( = .033) and functional status ( = .011) were statistically independent predictors of high complexity.

DISCUSSION

This study has shown that a high proportion of hospitalized palliative care cancer patients have high complexity, suggesting a good matching of healthcare resources to patient complexity. Four factors related to complexity have been identified, namely pain, nausea and vomiting, depression and a bedridden functional state. The presence of any of the 4 factors could help healthcare professionals to identify patients for early specialized palliative care.

摘要

引言

西班牙国家卫生系统将复杂性定义为一组增加难度的因素,这些因素需要姑息治疗团队的干预。姑息治疗旨在提高慢性绝症患者的生活质量。本研究旨在描述姑息治疗中癌症患者的复杂程度,确定哪些复杂因素最为普遍,并确定哪些其他医院临床因素与复杂程度相关。

方法

本研究是一项描述性、观察性横断面分析,纳入了2023年3月至4月间入住米格尔·塞尔维特大学医院肿瘤内科病房、接受姑息治疗的晚期肿瘤病理诊断患者。

结果

共选取100例患者进行研究。根据国际疾病分类-姑息治疗(IDC-Pal),68%的患者被归类为高度复杂,26%的患者为复杂,仅6%的患者被归类为非复杂。疼痛(<.001)、恶心和呕吐(=.027)、抑郁(=.033)和功能状态(=.011)是高度复杂性的统计学独立预测因素。

讨论

本研究表明,住院姑息治疗癌症患者中很大一部分具有高度复杂性,这表明医疗资源与患者复杂性匹配良好。已确定与复杂性相关的四个因素,即疼痛、恶心和呕吐、抑郁以及卧床功能状态。这四个因素中的任何一个因素的存在都可以帮助医疗专业人员识别适合早期专科姑息治疗的患者。

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