癌症住院康复患者接受整合肿瘤治疗的频率和特征。
Frequency and Characteristics of Integrative Oncology Referrals for Patients With Cancer Receiving Inpatient Rehabilitation.
机构信息
University of Texas MD Anderson Cancer Center, Houston, TX, USA.
University of Texas, Austin, TX, USA.
出版信息
Integr Cancer Ther. 2024 Jan-Dec;23:15347354241296810. doi: 10.1177/15347354241296810.
BACKGROUND
Integrative Oncology (IO) interventions may decrease physical, psychological, and social distress related to cancer and its treatments. Little is known about the frequency and predictors of IO referral for symptom management for cancer rehabilitation inpatients.
METHODS
A retrospective review was performed of patients with cancer who underwent inpatient rehabilitation at a specialized tertiary cancer center from 5/2016 to 3/2020. Patient demographics and IO consultation details, including patient-reported outcome measures of symptom burden using ESAS-FS and functional status using the Activity Measure for Post-Acute Care "6 clicks," were extracted. Descriptive summary statistics and logistic regression were used to analyze the data.
RESULTS
Out of 1196 inpatient rehabilitation admissions, 100 (8.4%) were referred to IO. The Activity Measure for Post-Acute Care "6 clicks" basic mobility admission scores were significant at a 1-point difference between the intervention and control group (39.5 vs 40.8, < .05); both scores equate to a ˃50% degree of functional impairment. Referred patients were younger (62, = .02) and Hispanics or Latinos ( = .02). The top symptoms for IO consultation included pain (N = 73), integrative approach (N = 41), relaxation (N = 38), and stress/anxiety (N = 33). Patients who reported a baseline symptom score ≥ 1 in the ESAS-FS, had both statistically ( < .05) and clinically significant improvements (≥1 point change) for pain, fatigue, well-being, anxiety, and sleep after massage therapy.
CONCLUSION
Cancer rehabilitation inpatients were commonly referred to IO to address pain, with observed improvements across multiple symptoms with massage therapy. Lower mobility scores and younger patients received significantly higher referrals to IO. Larger trials are needed to characterize the effects of IO interventions on the inpatient rehabilitation of patients with cancer.
背景
整合肿瘤学（IO）干预措施可能会减轻与癌症及其治疗相关的身体、心理和社会困扰。对于癌症康复住院患者接受 IO 转诊进行症状管理的频率和预测因素知之甚少。
方法
对 2016 年 5 月至 2020 年 3 月在一家专门的三级癌症中心接受住院康复治疗的癌症患者进行回顾性审查。提取患者的人口统计学数据和 IO 咨询详细信息，包括使用 ESAS-FS 报告的症状负担和使用“6 次点击”活动测量康复后护理的功能状态。使用描述性汇总统计和逻辑回归分析数据。
结果
在 1196 例住院康复入院患者中，有 100 例（8.4%）被转诊至 IO。干预组和对照组之间，“6 次点击”基本活动能力入院评分相差 1 分具有显著差异（39.5 比 40.8， < .05）；两个分数都表示功能障碍程度>50%。被转诊的患者更年轻（62， = .02），且为西班牙裔或拉丁裔（ = .02）。IO 咨询的主要症状包括疼痛（N = 73）、综合方法（N = 41）、放松（N = 38）和压力/焦虑（N = 33）。在 ESAS-FS 中报告基线症状评分 ≥ 1 的患者，在接受按摩治疗后，疼痛、疲劳、幸福感、焦虑和睡眠等症状均有统计学意义上（ < .05）和临床意义上（≥1 分变化）的改善。
结论
癌症康复住院患者通常会被转诊至 IO 以缓解疼痛，并且在按摩治疗后，多个症状均有改善。移动能力评分较低和较年轻的患者被转诊至 IO 的比例显著更高。需要更大规模的试验来描述 IO 干预对癌症患者住院康复的影响。
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