Abstract：
OBJECTIVE: The early integration of palliative care for terminally ill cancer patients improves quality of life. We have developed a new nurse-led consultation model for use in a palliative care consultation service (PCCS) to initiate early palliative care for cancer patients.
METHODS: In this 11-year observational study, data were collected from the Hospice-Palliative Clinical Database (HPCD) of Taichung Veterans General Hospital (TCVGH). Terminally ill cancer patients who had received PCCS during the years 2011 to 2021 were enrolled. Trend analysis was performed in order to evaluate differences in outcomes seen within the categories of either a nurse-led consultation model or ordinary consultation model throughout the study period. Analysis included studying the duration of PCCS and DNR declaration, as well as awareness of disease by both patients and families before and after PCCS.
RESULTS: In total, 6923 cancer patients with an average age of 64.1 years received PCCS from 2011 to 2021, with the average duration of PCCS being 11.1 days. Three thousand four hundred twenty-one patients (49.4%) received both a nurse consultation and doctor consultation during PCCS. Being admitted to the Department of Hematology, a longer duration of hospitalization, a DNR declaration after PCCS, and having had a PCCS consultation by a nurse only or both with a nurse and a doctor were significant determinants of a PCCS duration of more than 7 days.
CONCLUSIONS: This 11-year observational study shows that the number of terminal cancer patients receiving a novel nurse-led consultation during PCCS has increased significantly during the past decade, while a nurse-led consultation model during PCCS was effective in improving the duration of PCCS among terminally ill cancer patients.
METHODS: In this 11-year observational study, data were collected from the Hospice-Palliative Clinical Database (HPCD) of Taichung Veterans General Hospital (TCVGH). Terminally ill cancer patients who had received PCCS during the years 2011 to 2021 were enrolled. Trend analysis was performed in order to evaluate differences in outcomes seen within the categories of either a nurse-led consultation model or ordinary consultation model throughout the study period. Analysis included studying the duration of PCCS and DNR declaration, as well as awareness of disease by both patients and families before and after PCCS.
RESULTS: In total, 6923 cancer patients with an average age of 64.1 years received PCCS from 2011 to 2021, with the average duration of PCCS being 11.1 days. Three thousand four hundred twenty-one patients (49.4%) received both a nurse consultation and doctor consultation during PCCS. Being admitted to the Department of Hematology, a longer duration of hospitalization, a DNR declaration after PCCS, and having had a PCCS consultation by a nurse only or both with a nurse and a doctor were significant determinants of a PCCS duration of more than 7 days.
CONCLUSIONS: This 11-year observational study shows that the number of terminal cancer patients receiving a novel nurse-led consultation during PCCS has increased significantly during the past decade, while a nurse-led consultation model during PCCS was effective in improving the duration of PCCS among terminally ill cancer patients.
摘要：
目的：晚期癌症患者姑息治疗的早期整合提高了生活质量。我们开发了一种新的由护士主导的咨询模型，用于姑息治疗咨询服务（PCCS），以启动癌症患者的早期姑息治疗。
方法：在这项为期11年的观察性研究中，数据来自台中退伍军人总医院(TCVGH)的临终关怀姑息临床数据库(HPCD).纳入2011年至2021年期间接受PCCS的晚期癌症患者。进行趋势分析，以评估在整个研究期间，在护士主导的咨询模式或普通咨询模式类别中观察到的结果差异。分析包括研究PCCS和DNR声明的持续时间，以及PCCS前后患者和家属对疾病的认识。
结果：总计，从2011年到2021年，6923名平均年龄为64.1岁的癌症患者接受了PCCS，PCCS的平均持续时间为11.1天。在PCCS期间，三千四百二十一名患者（49.4％）接受了护士咨询和医生咨询。被血液内科录取，住院时间较长,PCCS后的DNR声明，并且仅由护士或同时由护士和医生进行PCCS会诊是PCCS持续时间超过7天的重要决定因素.
结论：这项为期11年的观察性研究表明，在过去十年中，在PCCS期间接受新的护士主导咨询的晚期癌症患者数量显着增加，而PCCS期间由护士主导的会诊模式可有效改善晚期癌症患者的PCCS持续时间.
方法：在这项为期11年的观察性研究中，数据来自台中退伍军人总医院(TCVGH)的临终关怀姑息临床数据库(HPCD).纳入2011年至2021年期间接受PCCS的晚期癌症患者。进行趋势分析，以评估在整个研究期间，在护士主导的咨询模式或普通咨询模式类别中观察到的结果差异。分析包括研究PCCS和DNR声明的持续时间，以及PCCS前后患者和家属对疾病的认识。
结果：总计，从2011年到2021年，6923名平均年龄为64.1岁的癌症患者接受了PCCS，PCCS的平均持续时间为11.1天。在PCCS期间，三千四百二十一名患者（49.4％）接受了护士咨询和医生咨询。被血液内科录取，住院时间较长,PCCS后的DNR声明，并且仅由护士或同时由护士和医生进行PCCS会诊是PCCS持续时间超过7天的重要决定因素.
结论：这项为期11年的观察性研究表明，在过去十年中，在PCCS期间接受新的护士主导咨询的晚期癌症患者数量显着增加，而PCCS期间由护士主导的会诊模式可有效改善晚期癌症患者的PCCS持续时间.
