支持性护理2030运动：迈向统一全球卓越支持性癌症护理的目标——一项国际德尔菲研究

Supportive care 2030 movement: towards unifying ambitions for global excellence in supportive cancer care-an international Delphi study.

作者信息

Chan Raymond Javan, Knowles Reegan, Ashbury Fredrick D, Bowen Joanne, Chan Alexandre, Chin Melissa, Olver Ian, Taylor Carolyn, Tinianov Stacey, Alberti Paola, Bossi Paolo, Brito-Dellan Norman, Cooksley Tim, Crawford Gregory Brian, Dixit Niharika, Fitch Margaret I, Freedman Jason L, Ginex Pamela K, Hart Nicolas H, Hertz Daniel L, Jefford Michael, Koczwara Bogda, Naito Tateaki, Orsey Andrea Dahlman, Ruhlmann Christina H, Tsoukalas Nikolaos, van den Hurk Corina, Van Sebille Ysabella, Wardill Hannah Rose, Scotte Florian, Lustberg Maryam

机构信息

Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Flinders Drive, Bedford Park, South Australia, Australia.

Department of Oncology, University of Calgary, Alberta, Canada.

出版信息

EClinicalMedicine. 2024 Sep 11;76:102825. doi: 10.1016/j.eclinm.2024.102825. eCollection 2024 Oct.

DOI:10.1016/j.eclinm.2024.102825

PMID:39309723

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11415959/

Abstract

BACKGROUND

Supportive care to ensure optimal quality of life is an essential component of cancer care and symptom control across the lifespan. Ongoing advances in cancer treatment, increasing toxicity from many novel treatment regimes, and variations in access to care and cancer outcomes across the globe and resource settings present significant challenges for supportive care delivery. To date, no overarching framework has been developed to guide supportive care development worldwide. As an initial step of the Multinational Association of Supportive Care in Cancer (MASCC) Supportive Care 2030 Movement, we developed a targeted, unifying set of ambition statements to envision the future of supportive cancer care.

METHODS

From September 2022 until June 2023, we used a modified Delphi methodology to develop and attain consensus about ambition statements related to supportive cancer care. Leaders of MASCC Study Groups were invited to participate in an Expert Panel for the first two Delphi rounds (and a preliminary round to suggest potential ambition statements). Patient Advocates then examined and provided input regarding the ambition statements.

FINDINGS

Twenty-seven Expert Panelists and 11 Patient Advocates participated. Consensus was attained on 13 ambition statements, with two sub-statements. The ambition statements addressed global standards for guideline development and implementation, coordinated and individualized care, dedicated supportive oncology services, self-management, needs for screening and actions, patient education, behavioral support, financial impact minimization, comprehensive survivorship care, and timely palliative care, reflecting collaboration, coordination and team-based approach across all levels.

INTERPRETATION

This study is the first to develop shared ambitions for the future of supportive cancer care on a global level. These ambition statements can facilitate a coordinated, resource-stratified, and person-centered approach and inform research, education, clinical services, and policy efforts.

FUNDING

This project received funding support from Prof Raymond Chan's NHMRC Investigator Grant (APP1194051).

摘要

背景

提供支持性护理以确保最佳生活质量是癌症护理和全生命周期症状控制的重要组成部分。癌症治疗的不断进步、许多新型治疗方案毒性的增加，以及全球不同资源环境下在获得护理和癌症治疗结果方面的差异，给支持性护理的提供带来了重大挑战。迄今为止，尚未制定一个总体框架来指导全球范围内的支持性护理发展。作为癌症支持性护理多国协会（MASCC）2030年支持性护理运动的第一步，我们制定了一套有针对性、统一的宏伟目标声明，以展望支持性癌症护理的未来。

方法

从2022年9月到2023年6月，我们采用了改良的德尔菲方法来制定与支持性癌症护理相关的宏伟目标声明并达成共识。MASCC研究小组的负责人被邀请参加前两轮德尔菲专家小组（以及一轮初步轮次以提出潜在的宏伟目标声明）。患者权益倡导者随后对这些宏伟目标声明进行审查并提供意见。

结果

27名专家小组成员和11名患者权益倡导者参与其中。就13项宏伟目标声明以及两项子声明达成了共识。这些宏伟目标声明涉及指南制定和实施的全球标准、协调和个性化护理、专门的支持性肿瘤学服务、自我管理、筛查需求和行动、患者教育、行为支持、将财务影响降至最低、全面的癌症生存护理以及及时的姑息治疗，反映了各级的协作、协调和基于团队的方法。