Department of Radiation Oncology, All India Institute of Medical Sciences (AIIMS), Mangalagiri, India.
Department of Community and Family Medicine (CFM), All India Institute of Medical Sciences (AIIMS), Mangalagiri, India.
Asian Pac J Cancer Prev. 2024 Nov 1;25(11):3789-3797. doi: 10.31557/APJCP.2024.25.11.3789.
Despite the widespread recognition of the need for new palliative care models to better serve advanced cancer patients at the end of life, little importance is given to assessing the effectiveness of homecare models.
This systematic review aims to summarize factors influencing the quality of life (QOL) of advanced cancer patients in home-based palliative care (HBPC) being adopted worldwide.
Following the PRISMA guidelines, electronic databases such as MEDLINE, Cochrane, EMBASE, and Scopus databases from 2000 to February 2024 were systematically searched using predetermined search terms of "quality of life", "home-based palliative care" as well as "advanced cancer". Studies with less than ten subjects, scoping reviews, conference abstracts, and that adopted poorly validated QOL questionnaires were excluded.
Twenty-two (22) studies from both developed and developing countries were included in the narrative synthesis. 45.4% were cross-sectional, 27.2% were prospective cohort studies, 13.6% were retrospective cohort studies, and 18.1% were RCTs or quasi-experimental studies. Around 33 QOL factors were studied with 16 different types of QOL instruments. Advanced cancer patients who practiced spirituality, female gender, were married, had satisfaction with care, and preferred home as a place of death showed higher QOL scores. Older patients, aware of cancer diagnosis, poor performance status, high pain score, symptom distress, and psychological distress were associated with a poor QOL.
Various factors affect QOL among cancer patients in HBPC. Hence it shows the importance of interventions to improve QOL and their rigorous implementation. With the widespread adoption of multi-disciplinary home care palliative programs, palliative care services to advanced cancer patients can be delivered readily which may be cost-effective.
尽管人们普遍认识到需要新的姑息治疗模式来更好地为生命末期的晚期癌症患者提供服务，但很少有人重视评估家庭护理模式的效果。
本系统评价旨在总结全球范围内采用家庭为基础的姑息治疗（HBPC）对晚期癌症患者生活质量（QOL）的影响因素。
根据 PRISMA 指南，系统检索了 2000 年至 2024 年 2 月期间 MEDLINE、Cochrane、EMBASE 和 Scopus 等电子数据库，使用了“生活质量”、“家庭为基础的姑息治疗”和“晚期癌症”等预定检索词。排除了少于 10 例患者的研究、范围综述、会议摘要以及采用验证效果不佳的 QOL 问卷的研究。
纳入了来自发达国家和发展中国家的 22 项研究（叙述性综合分析）。45.4%为横断面研究，27.2%为前瞻性队列研究，13.6%为回顾性队列研究，18.1%为 RCT 或准实验研究。共研究了 33 个 QOL 因素，采用了 16 种不同类型的 QOL 工具。实践灵性、女性、已婚、对护理满意以及喜欢在家中去世的晚期癌症患者表现出更高的 QOL 评分。年龄较大、了解癌症诊断、较差的表现状态、较高的疼痛评分、症状困扰和心理困扰与较差的 QOL 相关。
各种因素影响 HBPC 中癌症患者的 QOL。因此，这表明需要采取干预措施来提高 QOL，并严格实施这些措施。随着多学科家庭姑息治疗方案的广泛采用，可以提供针对晚期癌症患者的姑息治疗服务，这可能具有成本效益。
