Centre for Crisis Psychology, University of Bergen, Bergen, Norway.
Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
BMC Palliat Care. 2024 Nov 18;23(1):267. doi: 10.1186/s12904-024-01586-1.
Incurable cancer is a major contributor to societal suffering and disability, and palliative rehabilitation is recommended to be integrated within and between cancer services at all healthcare levels. However, little knowledge exists on how integration of palliative rehabilitation in cancer is understood and achieved in clinical practice. INSPIRE (Integrated short-term palliative rehabilitation to improve quality of life and equitable care access in incurable cancer) is a large European-funded project that aims to promote quality of life through a novel rehabilitation model for people disabled by advanced cancer.
To compare the existing integration of palliative rehabilitation in cancer within official documents and in clinical practice across five European countries including United Kingdom, France, Denmark, Norway, and Italy.
Mixed methods study with a concurrent research design, comprising a document analysis (N = 23), stakeholder interviews (N = 22), and an online survey (N = 225). Data from each sub-study were analysed separately before results were merged.
There was limited integration of palliative rehabilitation in cancer in official documents and in clinical practice, though some indicators of integration, including participation in multidisciplinary teams and adherence to standardised pathways, were identified in the survey. Notably, integration of palliative rehabilitation in cancer in clinical practice was observed within limited organisations in secondary healthcare systems, without widespread adoption. Although palliative rehabilitation in cancer as a concept was sparingly used by stakeholders, they recognised the need for a comprehensive approach including multidisciplinary teams that aligns with the individual patient's needs and goals. Moreover, the ambiguous distinction between the terms 'palliative rehabilitation' and 'palliative care', insufficient funding, lack of well-defined care pathways and competence gaps among healthcare professionals represented barriers to integration of palliative rehabilitation in cancer into clinical practice.
Integration of palliative rehabilitation in cancer was limited in the five EU partnership countries investigated. Clarifying the concept of palliative rehabilitation, including adoption of the concept into official documents and delineating it from palliative care, is essential for more successful integration. This can possibly be achieved by addressing the barriers identified and fostering close collaboration across disciplines.
无法治愈的癌症是导致社会痛苦和残疾的主要因素，建议在所有医疗保健层面的癌症服务中纳入姑息康复。然而，对于姑息康复在癌症中的整合方式以及在临床实践中的实施情况，我们知之甚少。INSPIRE（综合短期姑息康复以改善绝症患者的生活质量和公平获得护理）是一个大型的欧洲资助项目，旨在通过一种新的康复模式来提高患有晚期癌症的患者的生活质量。
比较英国、法国、丹麦、挪威和意大利等五个欧洲国家的官方文件和临床实践中姑息康复在癌症中的现有整合情况。
采用混合方法研究设计，包括文件分析（N=23）、利益攸关方访谈（N=22）和在线调查（N=225）。每个子研究的数据在合并结果之前单独进行分析。
在官方文件和临床实践中，姑息康复在癌症中的整合程度有限，尽管在调查中发现了一些整合指标，包括参与多学科团队和遵循标准化途径。值得注意的是，在二级医疗系统中，姑息康复在癌症中的整合仅在有限的组织中观察到，并未广泛采用。尽管利益攸关方很少使用姑息康复在癌症这一概念，但他们认识到需要采取包括多学科团队在内的综合方法，以满足个体患者的需求和目标。此外，姑息康复和姑息治疗这两个术语之间的界限模糊、资金不足、缺乏明确的护理途径以及医疗保健专业人员的能力差距，这些都是姑息康复在癌症中整合到临床实践中的障碍。
在调查的五个欧盟伙伴国家中，姑息康复在癌症中的整合程度有限。澄清姑息康复的概念，包括在官方文件中采用该概念并将其与姑息治疗区分开来，对于更成功的整合至关重要。这可以通过解决已确定的障碍和促进跨学科的密切合作来实现。
