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在逐步照护模式下每周使用综合姑息治疗结果量表(IPOS)的可行性

Feasibility of Weekly Integrated Palliative Care Outcome Scale (IPOS) Within a Stepped Care Model.

作者信息

Yang Grace Meijuan, Lee Yixuan, Ke Yu, Neo Patricia Soek Hui, Cheung Yin Bun

机构信息

Division of Supportive and Palliative Care (G.M.Y., Y.K., P.S.H.N., Y.B.), National Cancer Centre Singapore, Singapore; Lien Centre for Palliative Care (G.M.Y., Y.K., P.S.H.N., Y.B.), Duke-NUS Medical School, Singapore, Singapore; Programme in Health Services and Systems Research (G.M.Y., Y.K., P.S.H.N., Y.B.), Duke-NUS Medical School, Singapore, Singapore.

Duke-NUS Medical School (Y.L.), Singapore, Singapore.

出版信息

J Pain Symptom Manage. 2024 Sep;68(3):e174-e182. doi: 10.1016/j.jpainsymman.2024.06.004. Epub 2024 Jun 13.

Abstract

CONTEXT

Patients with advanced cancer may experience symptoms and concerns that are inadequately identified by the healthcare team, leading to calls for patient-reported symptom monitoring.

OBJECTIVES

Assess the feasibility of administering weekly patient-reported online Integrated Palliative care Outcome Scale (IPOS) questionnaires within the context of a stepped care model in the outpatient care setting.

METHODS

Analysis of intervention group data in a randomized controlled trial to assess the effectiveness of a stepped care model of palliative care for patients with advanced cancer. Patients in the intervention group were invited to complete the IPOS weekly for 16 weeks through a remotely-administered online questionnaire. At the end of the 16-week period, patients were invited to complete a feedback survey. Multivariable logistic regression was used to assess factors associated with more versus less than 70% completion of weekly questionnaires.

RESULTS

Among 111 patients who survived more than 16 weeks, the mean number of questionnaires completed was 9.2/16 (58%). A total of 53 out of the 111 patients (48%) completed more than 70% of the questionnaires. Higher education level was found to be associated with higher completion of the questionnaires. A total of 79 out of 111 (71%) patients responded to the feedback survey, of which 67 (85%) felt comfortable with completing the online questionnaire and 11 (14%) felt it was troublesome to complete it on a weekly basis.

CONCLUSION

In our study, there was suboptimal completion of patient-reported IPOS questionnaire. Further research is needed to improve the uptake of patient-reported outcomes in real-world clinical settings.

摘要

背景

晚期癌症患者可能会出现一些症状和担忧,但医疗团队对此识别不足,因此需要患者报告症状监测。

目的

评估在门诊护理环境中的分级护理模式下,每周让患者报告在线综合姑息治疗结果量表(IPOS)问卷的可行性。

方法

对一项随机对照试验中的干预组数据进行分析,以评估姑息治疗分级护理模式对晚期癌症患者的有效性。干预组的患者被邀请通过远程管理的在线问卷,每周完成IPOS问卷,为期16周。在16周结束时,邀请患者完成一份反馈调查。采用多变量逻辑回归分析与每周问卷完成率超过70%或低于70%相关的因素。

结果

在111名存活超过16周的患者中,问卷完成的平均数量为9.2/16(58%)。111名患者中有53名(48%)完成了超过70%的问卷。发现较高的教育水平与较高的问卷完成率相关。111名患者中有79名(71%)回复了反馈调查,其中67名(85%)对完成在线问卷感到满意,11名(14%)觉得每周完成问卷很麻烦。

结论

在我们的研究中,患者报告的IPOS问卷完成情况不理想。需要进一步研究以提高现实临床环境中患者报告结果的接受度。

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