Weston Park Cancer Centre, Sheffield Teaching Hospitals NHS Trust, United Kingdom.
Sheffield Hallam University, United Kingdom.
Eur J Oncol Nurs. 2024 Aug;71:102611. doi: 10.1016/j.ejon.2024.102611. Epub 2024 May 23.
Frailty influences outcomes in patients with cancer and should be considered when making decisions about treatment but concerns have been raised about possible negative consequences of doing this. Many patients with lung cancer have attributes of frailty and this study explores patient and staff perspectives on its role in decision making in older people with lung cancer.
The study adopted a two-phase qualitative approach using semi-structured telephone interviews and an in-person focus group. Data was analysed using framework techniques.
Three key themes were identified: describing frailty, assessing frailty and perceptions of frailty. Each presented opportunities and challenges for using frailty in the context of treatment decision making. Frailty was described in relation to diverse attributes which made it difficult to define and assess. It was also associated with negative connotations, particularly by patients.
Frailty has the potential to inform decision making that balances the wish to provide optimum treatment against risks to patients who may not be able to tolerate it. The challenge for healthcare staff is to incorporate frailty assessment into clinical practice in a way that is acceptable to patients and avoids potential unintended harms.
虚弱会影响癌症患者的预后，在制定治疗决策时应予以考虑，但人们对这样做可能产生的负面影响表示担忧。许多肺癌患者具有虚弱的特征，本研究探讨了患者和医务人员对其在老年肺癌患者决策中的作用的看法。
该研究采用了两阶段定性方法，使用半结构化电话访谈和现场焦点小组。使用框架技术对数据进行分析。
确定了三个关键主题：描述虚弱、评估虚弱和对虚弱的看法。每个主题都为在治疗决策背景下使用虚弱提供了机会和挑战。虚弱与使定义和评估变得困难的各种特征有关。它也与负面含义有关，尤其是患者。
虚弱有可能为决策提供信息，在为可能无法耐受治疗的患者提供最佳治疗与风险之间取得平衡。医疗保健人员面临的挑战是将虚弱评估纳入临床实践，使患者能够接受，并避免潜在的意外伤害。
