Abstract：
OBJECTIVE: Generalist palliative care in hospital departments largely lacks an overall structure to fully manage the symptom burden and support needs of patients with incurable gastrointestinal cancer. Palliative care case management interventions show promising results in reducing healthcare use and enhancing quality of life. Less is known about these interventions and their potential to improve the quality of generalist palliative care in hospital departments. The aim of this study was to explore patients\' experience of a palliative care case management intervention (PalMaGiC) to acquire knowledge about its advantages and disadvantages and, if needed, adjust the intervention.
METHODS: Qualitative semi-structured interviews with patients (n = 14) with incurable gastrointestinal cancers of the oesophagus, pancreas, colon, or rectum were conducted and analysed using content analysis. Participants in the study were affiliated with PalMaGiC, an intervention in a gastroenterology department based on symptom assessment, care planning, care coordination, and needs-based follow-up.
RESULTS: Participants perceived the intervention as filling a gap and as a secure lifeline in the healthcare system since it provided 24-h access, a designated specialist nurse, and a patient-healthcare alliance. Using a needs-based approach, PalMaGiC changed the participants\' focus from disease to quality of life. Participants requested more open dialog within complementary and alternative medicine, greater focus on promoting hope and using need assessment questionnaires differently in assessing symptoms and problems.
CONCLUSIONS: The PalMaGiC intervention can potentially meet the needs of patients requiring palliative care in hospital departments, but further development of the content and personalised approach is needed.
METHODS: Qualitative semi-structured interviews with patients (n = 14) with incurable gastrointestinal cancers of the oesophagus, pancreas, colon, or rectum were conducted and analysed using content analysis. Participants in the study were affiliated with PalMaGiC, an intervention in a gastroenterology department based on symptom assessment, care planning, care coordination, and needs-based follow-up.
RESULTS: Participants perceived the intervention as filling a gap and as a secure lifeline in the healthcare system since it provided 24-h access, a designated specialist nurse, and a patient-healthcare alliance. Using a needs-based approach, PalMaGiC changed the participants\' focus from disease to quality of life. Participants requested more open dialog within complementary and alternative medicine, greater focus on promoting hope and using need assessment questionnaires differently in assessing symptoms and problems.
CONCLUSIONS: The PalMaGiC intervention can potentially meet the needs of patients requiring palliative care in hospital departments, but further development of the content and personalised approach is needed.
摘要：
目的：医院科室的普适姑息治疗在很大程度上缺乏一个全面的结构来全面管理无法治愈的胃肠道癌症患者的症状负担和支持需求。姑息治疗病例管理干预措施在减少医疗保健使用和提高生活质量方面显示出有希望的结果。人们对这些干预措施及其在提高医院科室通识姑息治疗质量方面的潜力知之甚少。这项研究的目的是探索姑息治疗病例管理干预（PalMaGiC）的患者经验，以获取有关其优缺点的知识，如果需要,调整干预措施。
方法：对无法治愈的食道癌患者（n=14）进行定性半结构化访谈，胰腺,结肠,或直肠进行了分析，使用内容分析。该研究的参与者隶属于PalMaGiC，根据症状评估对消化内科进行干预，护理规划,护理协调，以及基于需求的后续行动。
结果：参与者认为干预措施填补了空白，并且是医疗保健系统中的安全生命线，因为它提供了24小时的访问权限，指定的专科护士,和病人医疗联盟。使用基于需求的方法，PalMaGiC将参与者的关注点从疾病转移到生活质量。参与者要求在补充和替代医学中进行更多的公开对话，更加注重促进希望，并在评估症状和问题时不同地使用需求评估问卷。
结论：PalMaGiC干预有可能满足医院科室需要姑息治疗的患者的需求，但需要进一步发展内容和个性化方法。
方法：对无法治愈的食道癌患者（n=14）进行定性半结构化访谈，胰腺,结肠,或直肠进行了分析，使用内容分析。该研究的参与者隶属于PalMaGiC，根据症状评估对消化内科进行干预，护理规划,护理协调，以及基于需求的后续行动。
结果：参与者认为干预措施填补了空白，并且是医疗保健系统中的安全生命线，因为它提供了24小时的访问权限，指定的专科护士,和病人医疗联盟。使用基于需求的方法，PalMaGiC将参与者的关注点从疾病转移到生活质量。参与者要求在补充和替代医学中进行更多的公开对话，更加注重促进希望，并在评估症状和问题时不同地使用需求评估问卷。
结论：PalMaGiC干预有可能满足医院科室需要姑息治疗的患者的需求，但需要进一步发展内容和个性化方法。
