Abstract：
BACKGROUND: Though patients undergoing treatment for upper gastrointestinal (GI) cancers frequently experience a range of sequelae and disease recurrence, patients often do not receive specialty palliative care soon after diagnosis and it is unknown in what ways they may benefit.
OBJECTIVE: To understand patient experiences of specialty palliative care in the perioperative period for patients seeking curative intent upper GI oncologic surgery.
METHODS: As part of a randomized controlled trial, we conducted in-depth interviews between November 2019 and July 2021 with 23 patients in the intervention arm who were undergoing curative intent treatment for upper GI cancers and who were also followed by the specialty palliative care team.
RESULTS: We found five themes that characterized patient experiences and perceptions of specialty palliative care. Patients typically had limited prior awareness of palliative care (theme 1), but during the study, came to understand it as a \"talking\" intervention (theme 2). Patients whose concerns aligned with palliative care described it as being impactful on their care (theme 3). However, most patients expressed a focus on cure from their cancer and less perceived relevance for integration of palliative care (theme 4). Integrating specialist palliative care practitioners with surgical teams made it difficult for some patients to identify how palliative care practitioners differed from other members of their care team (theme 5).
CONCLUSIONS: While receipt of specialty palliative care in the perioperative period was generally perceived positively and patients appreciated palliative care visits, they did not describe many needs typically met by palliative care practitioners.
BACKGROUND: clinicaltrials.gov registration: NCT03611309.
OBJECTIVE: To understand patient experiences of specialty palliative care in the perioperative period for patients seeking curative intent upper GI oncologic surgery.
METHODS: As part of a randomized controlled trial, we conducted in-depth interviews between November 2019 and July 2021 with 23 patients in the intervention arm who were undergoing curative intent treatment for upper GI cancers and who were also followed by the specialty palliative care team.
RESULTS: We found five themes that characterized patient experiences and perceptions of specialty palliative care. Patients typically had limited prior awareness of palliative care (theme 1), but during the study, came to understand it as a \"talking\" intervention (theme 2). Patients whose concerns aligned with palliative care described it as being impactful on their care (theme 3). However, most patients expressed a focus on cure from their cancer and less perceived relevance for integration of palliative care (theme 4). Integrating specialist palliative care practitioners with surgical teams made it difficult for some patients to identify how palliative care practitioners differed from other members of their care team (theme 5).
CONCLUSIONS: While receipt of specialty palliative care in the perioperative period was generally perceived positively and patients appreciated palliative care visits, they did not describe many needs typically met by palliative care practitioners.
BACKGROUND: clinicaltrials.gov registration: NCT03611309.
摘要：
背景：尽管接受上消化道（GI）癌症治疗的患者经常经历一系列后遗症和疾病复发，患者通常在诊断后不久就不会接受特殊的姑息治疗，并且未知他们可能在哪些方面受益。
目的：了解寻求根治性上消化道肿瘤手术的患者在围手术期接受专业姑息治疗的经验。
方法：作为一项随机对照试验的一部分，我们在2019年11月至2021年7月间对介入治疗组的23例患者进行了深度访谈,这些患者正在接受上消化道癌症的根治性意向治疗,并由专业姑息治疗团队随访.
结果：我们发现了五个主题，这些主题表征了患者对特殊姑息治疗的体验和看法。患者通常对姑息治疗的认识有限（主题1），但在研究期间,开始将其理解为“谈话”干预(主题2)。关注与姑息治疗一致的患者将其描述为对他们的护理有影响（主题3）。然而,大多数患者表示关注癌症的治愈,而认为姑息治疗整合的相关性较低(主题4).将专业姑息治疗从业者与手术团队相结合，使某些患者很难确定姑息治疗从业者与其他护理团队成员之间的差异（主题5）。
结论：虽然在围手术期接受专业姑息治疗通常被认为是积极的，并且患者赞赏姑息治疗就诊，他们没有描述许多通常由姑息治疗从业者满足的需求.
目的：了解寻求根治性上消化道肿瘤手术的患者在围手术期接受专业姑息治疗的经验。
方法：作为一项随机对照试验的一部分，我们在2019年11月至2021年7月间对介入治疗组的23例患者进行了深度访谈,这些患者正在接受上消化道癌症的根治性意向治疗,并由专业姑息治疗团队随访.
结果：我们发现了五个主题，这些主题表征了患者对特殊姑息治疗的体验和看法。患者通常对姑息治疗的认识有限（主题1），但在研究期间,开始将其理解为“谈话”干预(主题2)。关注与姑息治疗一致的患者将其描述为对他们的护理有影响（主题3）。然而,大多数患者表示关注癌症的治愈,而认为姑息治疗整合的相关性较低(主题4).将专业姑息治疗从业者与手术团队相结合，使某些患者很难确定姑息治疗从业者与其他护理团队成员之间的差异（主题5）。
结论：虽然在围手术期接受专业姑息治疗通常被认为是积极的，并且患者赞赏姑息治疗就诊，他们没有描述许多通常由姑息治疗从业者满足的需求.
