姑息治疗与肿瘤学早期整合影响（IEI PCO）问卷的开发与验证：一项针对肿瘤内科医生和护士的调查
Development and validation of impact of early integration of palliative care and oncology(IEI PCO) questionnaire: a survey for medical oncologists and nurses.
作者信息
Abdullah Abdulrahman Abdulaziz, Abd-El-Gawad Wafaa Mostafa, AboSerea Sobhi Mostafa, Ali Fatma AbdelShakor, Ali Saima
机构信息
Consultant and Head of Palliative Medicine Department, Palliative Care Center, Kuwait, Kuwait.
Associate Professor of Geriatrics and Gerontology Medicine, Geriatrics and Gerontology Department,Faculty of Medicine,, Ain Shams University, Al-Abbaseya, Cairo, Egypt.
出版信息
BMC Palliat Care. 2024 Apr 26;23(1):109. doi: 10.1186/s12904-024-01435-1.
OBJECTIVES
Many associations have recently recommended early integration of oncology and palliative care for more standard cancer care and better quality of life. We aimed to create a questionnaire to assess the opinion of medical oncologists and nurses about the clinical impact of the integrated palliative care and oncology (PCO) program.
METHODS
A novel semi-structured questionnaire called Impact of Early Integration of Palliative Care Oncology (IEI PCO) questionnaire was developed and tested for validity and reliability then distributed to the oncologists and nurses working in Kuwait Cancer Control Center.
RESULTS
After the pilot stage, testing the final questionnaire for validity and reliability was done with satisfactory results. Finally, the complete questionnaires were 170 out of 256 (response rate 66.41%). More awareness about the available palliative care services and the new available PCO services (p-value < 0.001 for all). Most of the oncologists and nurses agreed with the currently available structure of PCO, appreciated the patients' discharge plan and continuity of care of palliative medicine, admitted less work burden, a better attitude, and higher satisfaction (p-value for all < 0.001) toward palliative care. Significant improvements in symptoms were appreciated by oncologists and nurses after the integration of palliative care (p-value for all < 0.001. Oncologists and nurses valued repeated honest communication, discussion of the goals of care, dealing more effectively with ending active treatment, and higher acceptance of patients and families of PC policy of transfer, and significant progress in the care of end-of-life symptoms (p-value for all < 0.001).
CONCLUSIONS
The IEI PCO questionnaire demonstrated the psychometric criteria for content, face, and construct validity and reliability. It provides a valuable tool to assess the impact of PCO integration. The opinion of medical oncologists and nurses was significantly positive toward the early integration of PCO in Kuwait in most aspects of care. This integration led to improved symptom control, end-of-life care, communication, and planned discharge and follow-up plans. Moreover, decreases the work burden, improves attitude, higher satisfaction of the oncology staff, and continuity of care.
目的
最近许多协会建议将肿瘤学与姑息治疗早期整合，以实现更规范的癌症护理并提高生活质量。我们旨在创建一份问卷，以评估肿瘤内科医生和护士对姑息治疗与肿瘤学综合（PCO）项目临床影响的看法。
方法
开发了一种名为姑息治疗与肿瘤学早期整合影响（IEI PCO）问卷的新型半结构化问卷，并对其有效性和可靠性进行测试，然后分发给在科威特癌症控制中心工作的肿瘤内科医生和护士。
结果
在试点阶段之后，对最终问卷进行了有效性和可靠性测试，结果令人满意。最终，256份问卷中收回完整问卷170份（回复率66.41%）。对现有姑息治疗服务和新的PCO服务有了更多了解（所有p值均<0.001）。大多数肿瘤内科医生和护士赞同当前PCO的现有架构，赞赏患者出院计划和姑息医学护理的连续性，承认工作负担减轻、态度更好且对姑息治疗的满意度更高（所有p值均<0.001）。在整合姑息治疗后，肿瘤内科医生和护士认识到症状有显著改善（所有p值均<0.001）。肿瘤内科医生和护士重视反复进行坦诚沟通、讨论护理目标、更有效地处理积极治疗的结束、患者及其家属对姑息治疗转诊政策更高的接受度以及临终症状护理方面的显著进展（所有p值均<0.001）。
结论
IEI PCO问卷展示了内容、表面和结构效度及信度的心理测量标准。它为评估PCO整合的影响提供了一个有价值的工具。在科威特，肿瘤内科医生和护士对PCO早期整合在大多数护理方面的看法呈显著积极态度。这种整合带来了症状控制、临终护理、沟通以及计划出院和随访计划的改善。此外，减轻了工作负担，改善了态度，提高了肿瘤医护人员的满意度以及护理的连续性。
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