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放疗科对骨转移癌患者姑息治疗与肿瘤治疗的及时整合:一项关于可接受性和可行性的初步研究

Timely integration of palliative care into oncology care for patients with bone metastases at the radiotherapy department: A pilot study on acceptability and feasibility.

作者信息

van Oss Anouk, Stoppelenburg Arianne, de Nijs Ellen, van Jaarsveld Rebecca, Heipon Carly S, Raijmakers Natasja J H, van der Linden Yvette M

机构信息

Center of Expertise for Palliative Care, Leiden University Medical Center, Leiden, the Netherlands.

Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.

出版信息

Tech Innov Patient Support Radiat Oncol. 2025 Jun 10;35:100317. doi: 10.1016/j.tipsro.2025.100317. eCollection 2025 Sep.

Abstract

BACKGROUND AND AIM

Patients with bone metastases may have needs that extend beyond the management of pain by radiotherapy. Concurrent palliative care leads to improved quality of life, but is often introduced late. In this pilot study, we assessed the acceptability and feasibility of an introdu0000ctory conversation with a palliative care consultant at referral for palliative radiotherapy.

MATERIAL AND METHODS

Patients with bone metastases and their family caregivers were scheduled for an introductory conversation with a consultant from the hospital palliative care team. During this meeting, the potential benefits of integrating palliative care into their current or future care was discussed. Using statements on a 5-point Likert scale, patients and family caregivers independently evaluated the acceptability of the conversation, and consultants evaluated the feasibility.

RESULTS

Between December 2022 and March 2024, 48 patients were included in the study. Median age was 73 years, 63 % were male. Most patients (89 %) and family caregivers (96 %) appreciated the introductory conversation, were unaware of the existence of a palliative care team (60 %, 67 %, respectively), and would contact the team when having questions or concerns (77 %, 82 %). Some found the conversation confronting (17 %, 11 %), or felt it was too early in the illness trajectory (31 %, 26 %). Follow-up consultations were scheduled for 8 patients (17 %). Consultants were able to conduct the conversation as instructed (91 %), though 15 % indicated insufficient time for preparation.

CONCLUSION

Introductory conversations about palliative care at referral for palliative radiotherapy appear both acceptable and feasible, and may enhance timely integration of palliative care into oncology care for patients with bone metastases.

摘要

背景与目的

骨转移患者的需求可能不仅限于通过放疗来控制疼痛。姑息治疗可提高生活质量,但往往在病程后期才开始实施。在这项试点研究中,我们评估了在转介接受姑息性放疗时与姑息治疗顾问进行初步谈话的可接受性和可行性。

材料与方法

骨转移患者及其家庭护理人员安排与医院姑息治疗团队的顾问进行初步谈话。在此次会面中,讨论了将姑息治疗纳入其当前或未来护理的潜在益处。患者和家庭护理人员使用5级李克特量表对谈话的可接受性进行独立评估,顾问则评估可行性。

结果

在2022年12月至2024年3月期间,48名患者纳入研究。中位年龄为73岁,63%为男性。大多数患者(89%)和家庭护理人员(96%)对初步谈话表示赞赏,分别有60%和67%的人此前不知道有姑息治疗团队,77%的患者和82%的家庭护理人员表示在有问题或担忧时会联系该团队。一些人觉得谈话令人不安(分别为17%和11%),或者认为在疾病进程中为时过早(分别为31%和26%)。为8名患者(17%)安排了后续咨询。顾问能够按要求进行谈话(91%),不过15%的人表示准备时间不足。

结论

在转介接受姑息性放疗时就姑息治疗进行初步谈话似乎是可接受且可行的,可能会促进姑息治疗及时纳入骨转移患者的肿瘤护理中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/233f/12214256/8a0480cea69a/gr1.jpg

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