School of Health and Life sciences, University of the West of Scotland, Hamilton, UK.
School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
Curr Opin Support Palliat Care. 2024 Dec 1;18(4):235-242. doi: 10.1097/SPC.0000000000000728. Epub 2024 Oct 30.
This review aimed to explore recent progress made in the past five years towards early access to, and integration of palliative care services within the haemato-oncology context to address the unique needs of patients with Haematological malignancies (HMs).
We included 14 articles in our review. We identified three themes, namely (i) disparities in the timing of referrals remain, (ii) specialist palliative care and impact on quality of life and (iii) perceptions on early integration. Patients with HM, receive less palliative care services, regardless of their higher symptom burden compared to patients with solid tumours. Structured approaches and models of early integration have shown substantial benefits, including improved pain and symptom management, shorter hospital stays and better end of life planning. Perceptions on existing barriers include the curative treatment focus, haematologists' personal perceptions on timing of palliative care and lack of palliative care training.
For early integration to happen, it is crucial to address training gaps, improve communication skills, and foster interdisciplinary collaboration. Standardised organisational pathways can facilitate early and concurrent palliative care integration. System-level flexibility and supportive policies are essential to ensure that patients with HM receive comprehensive and high-quality care.
目的综述:本文旨在探讨过去五年间在血液肿瘤学背景下,为满足血液恶性肿瘤(HM)患者的特殊需求,实现姑息治疗服务的早期获取和整合方面取得的最新进展。
发现:本综述共纳入 14 篇文章,确定了三个主题,即(i)转介时间仍存在差异,(ii)姑息治疗专家和对生活质量的影响,以及(iii)对早期整合的看法。与实体瘤患者相比,HM 患者的症状负担更高,但他们接受的姑息治疗服务却更少。早期整合的结构化方法和模式显示出显著的益处,包括改善疼痛和症状管理、缩短住院时间和更好的临终规划。对现有障碍的看法包括以治愈为重点的治疗方法、血液学家对姑息治疗时机的个人看法以及缺乏姑息治疗培训。
总结:为了实现早期整合,解决培训差距、提高沟通技巧和促进跨学科合作至关重要。标准化的组织途径可以促进姑息治疗的早期和同时整合。系统层面的灵活性和支持性政策对于确保 HM 患者获得全面和高质量的护理至关重要。