Sarna L, McCorkle R
School of Nursing, University of California, Los Angeles 90095-6918, USA.
Cancer Pract. 1996 Sep-Oct;4(5):245-51.
Although direct costs for treatment are important considerations in healthcare planning, the indirect costs of chronic care may have an even more profound impact on families. The burden of care of chronic illnesses is seldom addressed in healthcare policies. This article uses lung cancer as a model to illustrate the burden of care of chronic illness and to examine the many healthcare problems that affect patients, families, and society at large.
Lung cancer, as a major cause of morbidity and mortality, and the second most expensive cost of cancer care, will impact more than 1 million Americans and their families in the next decade. In this article, a health services model is used to address burden of care for people with lung cancer. Predisposing factors, enabling factors, and need for healthcare are considered. Lung cancer literature related to emotional status, functional status, and symptom distress are reviewed as they relate to the physical, emotional, and social aspects of the burden of care.
The increasing responsibilities of the family in providing care in the face of limited external support, and the consequences of that caregiving, for the patient and family, raise serious concerns for clinicians. With quality of life as the ultimate health outcome, clinicians are challenged to contribute to a research and policy agenda that addresses burden of care.
尽管治疗的直接成本是医疗保健规划中的重要考虑因素,但慢性病护理的间接成本可能对家庭产生更为深远的影响。慢性病护理负担在医疗政策中很少得到解决。本文以肺癌为例,说明慢性病护理负担,并探讨影响患者、家庭和整个社会的诸多医疗问题。
肺癌作为发病率和死亡率的主要原因,以及癌症护理中第二昂贵的疾病,在未来十年将影响超过100万美国人及其家庭。本文采用一种卫生服务模式来解决肺癌患者的护理负担问题。考虑了诱发因素、促成因素和医疗保健需求。回顾了与情绪状态、功能状态和症状困扰相关的肺癌文献,因为它们与护理负担的身体、情感和社会方面有关。
面对有限的外部支持,家庭在提供护理方面的责任日益增加,以及这种护理对患者和家庭的影响,引发了临床医生的严重关切。以生活质量作为最终的健康结果,临床医生面临着为解决护理负担的研究和政策议程做出贡献的挑战。