Sansom-Daly Ursula M, Evans Holly E, Darlington Anne-Sophie, Weaver Meaghann S, Rosenberg Abby R, Wiener Lori, Anazodo Antoinette, Sue Louise, Cable Maria, Fernando Ruwanthie A, Herbert Anthony R, Lindsay Toni, Cohn Richard J, Wakefield Claire E
Behavioural Sciences Unit, School of Clinical Medicine, UNSW Medicine and Health, Randwick Clinical Campus, Discipline of Paediatrics, University of New South Wales Sydney, Kensington, Australia.
Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.
J Palliat Med. 2024 Dec;27(12):1606-1617. doi: 10.1089/jpm.2024.0141. Epub 2024 Nov 26.
Access to timely, age-appropriate palliative care services and end-of-life communication are two standards of care for adolescents and young adults (AYAs) living with cancer where cure is uncertain or unlikely. Health professionals' capacity to facilitate these standards is critical. This study aimed to understand AYA oncology health professionals' experienced practices in, and barriers to, delivering these standards of care across palliative care and end-of-life communication in Australia, New Zealand, and the United Kingdom (UK). We invited health professionals to complete a survey examining access, barriers to, and practices around these standards of care. Tailored to local settings, our survey assessed current delivery of palliative care and end-of-life communication services (including advance care planning [ACP]) and barriers to implementation of these. In total, 148 interdisciplinary health professionals participated (89% female overall; 83% female in Australia, 88% female in New Zealand, and 98% female in the UK). Across countries, participants reported that most institutions had an AYA cancer program (74% overall). Introduction to palliative care services was most often prognosis dependent or . ACP was less frequently introduced than palliative care. The most endorsed barrier to palliative care team introduction, as well as ACP, was Our results indicate that there are common barriers to AYAs receiving palliative care, end-of-life communication, and ACP. Given that health professionals' confidence in this area can enable facilitation of early, age-appropriate communication, resources and training are urgently needed to bridge these practice gaps.
对于患有癌症且治愈希望渺茫的青少年及青年成年人（AYAs）而言，获得及时且符合其年龄阶段的姑息治疗服务以及临终沟通是两项护理标准。医疗专业人员促成这些标准的能力至关重要。本研究旨在了解澳大利亚、新西兰和英国的AYA肿瘤医疗专业人员在提供姑息治疗和临终沟通这两项护理标准方面的实践经验及障碍。我们邀请医疗专业人员完成一项调查，该调查审视了这些护理标准的获取情况、障碍及实践。根据当地情况量身定制，我们的调查评估了姑息治疗和临终沟通服务（包括预立医疗照护计划[ACP]）的当前提供情况以及实施这些服务的障碍。共有148名跨学科医疗专业人员参与（总体上89%为女性；澳大利亚83%为女性，新西兰88%为女性，英国98%为女性）。在各个国家，参与者报告称大多数机构都设有AYA癌症项目（总体上74%）。姑息治疗服务的介绍通常取决于预后情况或……。预立医疗照护计划的介绍比姑息治疗的介绍频率更低。对于引入姑息治疗团队以及预立医疗照护计划，最常被认可的障碍是……我们的结果表明，AYAs在接受姑息治疗、临终沟通和预立医疗照护计划方面存在共同障碍。鉴于医疗专业人员在这一领域的信心能够促成早期且符合年龄阶段的沟通，迫切需要资源和培训来弥合这些实践差距。
