提供者视角与姑息治疗的可及性：美国头颈外科学会（AHNS）调查
Provider Perspectives and Access to Palliative Care: An American Head and Neck Society (AHNS) Survey.
作者信息
Sriram Shreya, Owusu-Boahene Akua, Gersten Rebecca A, Gourin Christine G
机构信息
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, Maryland, USA.
Department of Medicine, Johns Hopkins Hospital, Baltimore, Maryland, USA.
出版信息
Head Neck. 2025 Feb;47(2):657-666. doi: 10.1002/hed.27957. Epub 2024 Oct 7.
BACKGROUND
To explore provider perspectives about palliative care (PC) in head and neck cancer (HNC) care.
METHODS
A 25-question electronic survey was disseminated to the membership of the American Head and Neck Society (AHNS) from April 10, 2023, through June 13, 2023.
RESULTS
Respondents were most likely to refer to PC at symptomatic disease progression (52%) or terminal diagnosis (29%) rather than at initial diagnosis (17%). Participants less likely to refer to PC were less likely to refer to symptomatic progression (8% vs. 39%, p = 0.0006) or address advance directives (62% vs. 87%, p = 0.0406). Symptom burden questionnaires were used by only 29% of respondents. Discordance was identified between self-reported and actual access to local inpatient and outpatient PC services.
CONCLUSIONS
Barriers to PC identified include a lack of established optimal timing of PC referral, a perceived lack of local access to PC, and a lack of uniform standardized assessment of symptom burden.
背景
探讨医疗服务提供者对头颈部癌（HNC）护理中姑息治疗（PC）的看法。
方法
2023年4月10日至2023年6月13日，向美国头颈协会（AHNS）成员发放了一份包含25个问题的电子调查问卷。
结果
受访者最有可能在症状性疾病进展期（52%）或终末期诊断时（29%）而非初始诊断时（17%）提及姑息治疗。不太可能提及姑息治疗的参与者提及症状进展的可能性较小（8%对39%，p = 0.0006）或处理预立医疗指示的可能性较小（62%对87%，p = 0.0406）。只有29%的受访者使用了症状负担问卷。在自我报告的当地住院和门诊姑息治疗服务实际可及性之间发现了不一致。
结论
已确定的姑息治疗障碍包括缺乏既定的最佳姑息治疗转诊时机、认为当地难以获得姑息治疗以及缺乏对症状负担的统一标准化评估。
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