Booth Georgeann, Wong Risa L, DeBlasio Richelle N, Rosenzweig Margaret, Schenker Yael
School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Palliative Research Center (PaRC), University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
J Palliat Med. 2025 Mar;28(3):326-334. doi: 10.1089/jpm.2024.0309. Epub 2024 Nov 28.
Mixed success with primary palliative care delivery models may be related to inadequate communication between members of the care team. We sought to describe the previously unexamined role of oncologists in an oncology nurse-led primary palliative care intervention study. We conducted a secondary analysis of data from Care Management by Oncology Nurses to Address Supportive Care Needs, a cluster-randomized controlled trial of a nurse-led primary palliative care intervention for adults with advanced cancer conducted at 17 community oncology clinics in Western Pennsylvania from 2016 to 2020. Nurses conducted three monthly study visits during which they developed care plans (CPs) with the patient and after which they updated the patient's oncologist. We characterized the level of oncologist involvement with the intervention. Of the 336 patients randomized to receive primary palliative care, 266 completed at least one study visit and 233 (88%) had at least one visit where the oncologist was updated afterward. Across 674 total study visits, the oncologist was updated in 553 (82%) of the visits, signifying the oncologist awareness of the intervention. Of the times the nurse updated the oncologist, a CP was presented 29% of the time (163/553). In a large trial of oncology nurse-led primary palliative care, oncologists were often aware of but infrequently involved with the intervention. Future primary palliative care interventions should consider communication and engagement among team members.
初级姑息治疗提供模式的成效参差不齐，这可能与护理团队成员之间沟通不足有关。我们试图描述肿瘤学家在一项由肿瘤学护士主导的初级姑息治疗干预研究中此前未被审视的角色。我们对“肿瘤学护士护理管理以满足支持性护理需求”研究的数据进行了二次分析，该研究是一项在2016年至2020年期间于宾夕法尼亚州西部的17家社区肿瘤诊所开展的针对晚期癌症成人患者的由护士主导的初级姑息治疗干预的整群随机对照试验。护士进行了三次月度研究访视，在此期间他们与患者共同制定护理计划（CPs），之后向患者的肿瘤学家进行更新汇报。我们对肿瘤学家参与干预的程度进行了描述。在336名随机接受初级姑息治疗的患者中，266名完成了至少一次研究访视，233名（88%）至少有一次访视后向肿瘤学家进行了更新汇报。在总共674次研究访视中，有553次（82%）向肿瘤学家进行了更新汇报，这表明肿瘤学家知晓该干预措施。在护士向肿瘤学家更新汇报的情况中，有29%的次数（163/553）呈现了护理计划。在一项关于肿瘤学护士主导的初级姑息治疗的大型试验中，肿瘤学家通常知晓但很少参与该干预措施。未来的初级姑息治疗干预措施应考虑团队成员之间的沟通与参与情况。
