Klinik und Poliklinik für Innere Medizin C, Universitätsmedizin Greifswald, 17489, Greifswald, Germany.
Sarkomzentrum Berlin-Brandenburg, Helios Klinikum Bad Saarow, 15526, Bad Saarow, Germany.
Support Care Cancer. 2024 Jul 8;32(8):491. doi: 10.1007/s00520-024-08671-4.
Despite the significant impact of oral problems on the quality of life of palliative care patients, comprehensive studies are lacking. This study is the first of its kind to address this gap by including both a dental examination and an intervention and assessing quality of life using the EORTC QLQ OH 15 questionnaire.
The objective of this study is to explore the impact of incorporating dentists into inpatient palliative care, with a focus on enhancing quality of life and alleviating symptom burden.
In this monocentric study, data were gathered from a palliative care unit over an 8-month period. At the beginning of the multidisciplinary treatment, T0, patients underwent both a dental examination and interviews utilizing established questionnaires, the EORTC QLQ-C30 (core, general) and OH 15 (oral health). A week later, at T1, patients underwent a follow-up examination and interview. The QLQ-C30 and OH15 are widely recognized instruments developed by the European Organisation for Research and Treatment of Cancer (EORTC) for evaluating health related quality of life in cancer patients.
A total of n = 103 patients (48.5% women) were enrolled in the study. The median duration since their last dental visit was 1 year, and the dental condition at T0 was desolate. At T1, statistically and clinically significant changes in oral quality of life and symptom burden were observed. Noteworthy changes were noted in the OH-QoL score (median 63 vs. 92, p < 0.001), sticky saliva (median 33 vs. 0, p < 0.001), sensitivity to food and drink (median 33 vs. 0, p < 0.001), sore mouth (median 33 vs. 0, p > 0.001), and poorly fitting dentures (median 33 vs. 0 p < 0.001). Additionally, improvements were observed in xerostomia candidiasis and mucositis.
The study highlights the powerful contribution of integrating a dentist in inpatient palliative care. With very little dental effort and simple ward and bedside treatments, significant improvements in the oral symptom burden of critically ill palliative patients can be achieved. This contributes to improved care status, relief of distressing symptoms, and ultimately improved quality of life. The results strongly support the consideration of dental support as an integral part of palliative care units.
尽管口腔问题对姑息治疗患者的生活质量有重大影响,但缺乏全面的研究。本研究首次通过纳入牙科检查和干预措施,并使用 EORTC QLQ OH 15 问卷评估生活质量来填补这一空白。
本研究旨在探讨将牙医纳入住院姑息治疗的影响,重点是提高生活质量和减轻症状负担。
在这项单中心研究中,数据来自 8 个月的姑息治疗病房。在多学科治疗开始时(T0),患者接受了牙科检查和使用既定问卷(EORTC QLQ-C30(核心,一般)和 OH 15(口腔健康))进行的访谈。一周后(T1),患者接受了随访检查和访谈。QLQ-C30 和 OH15 是由欧洲癌症研究与治疗组织(EORTC)开发的广泛用于评估癌症患者健康相关生活质量的工具。
共纳入 103 例患者(48.5%为女性)。他们上次看牙医的时间中位数为 1 年,T0 时的口腔状况很差。在 T1,观察到口腔生活质量和症状负担有统计学和临床意义的改善。OH-QoL 评分(中位数 63 对 92,p<0.001)、粘性唾液(中位数 33 对 0,p<0.001)、对食物和饮料的敏感度(中位数 33 对 0,p<0.001)、口腔疼痛(中位数 33 对 0,p>0.001)和义齿不合适(中位数 33 对 0,p<0.001)方面有显著变化。此外,口干、念珠菌病和粘膜炎也有所改善。
该研究强调了将牙医纳入住院姑息治疗的强大贡献。通过非常小的牙科努力和简单的病房和床边治疗,可以显著改善重症姑息治疗患者的口腔症状负担。这有助于改善护理状况、缓解痛苦症状,并最终提高生活质量。结果强烈支持将牙科支持视为姑息治疗病房不可或缺的一部分。