Abstract：
Background: Despite physical and emotional distress in patients with gynecologic malignancies, palliative care (PC) is underutilized. Objectives: We characterize referral practices, symptom burden and functional status at the time of initial PC encounter for patients with gynecologic cancer. Design: Data were extracted from the standardized Quality Data Collection Tool for Palliative Care (QDACT-PC). We describe symptom burden and performance status. Results: At initial specialty PC encounter, patients with gynecologic cancers reported a mean of 3.3 moderate/severe symptoms. Outpatients experienced the most moderate/severe symptoms (mean 3.9) versus inpatient (mean 2.1) or home (mean 1.5). A total of 72.7% of patients had significantly impaired functional status (palliative performance scale [PPS] <70) at initial encounter. Inpatients had a more impaired functional status (mean PPS 48.8) than outpatients (mean PPS 67.0). Conclusions: The symptom burden for gynecologic cancer patients at initial PC encounter is high. Despite better functional status, patients referred in the outpatient setting had the highest symptom burden.
摘要：
背景：尽管妇科恶性肿瘤患者的身体和情绪困扰，姑息治疗（PC）未得到充分利用。目标：我们描述转诊实践，妇科癌症患者初次接触PC时的症状负担和功能状态。设计:从用于姑息治疗的标准化质量数据收集工具(QDACT-PC)中提取数据。我们描述了症状负担和表现状态。结果：在最初的专业PC相遇时，妇科癌症患者平均有3.3例中度/重度症状.门诊患者经历了最中度/重度症状（平均3.9）与住院患者（平均2.1）或家庭（平均1.5）。共有72.7%的患者在初次接触时具有显著的功能状态(姑息表现量表[PPS]<70)。住院患者的功能状态（平均PPS48.8）比门诊患者（平均PPS67.0）更受损。结论：妇科癌症患者初次接触PC时的症状负担很高。尽管功能状态更好，门诊转诊的患者症状负担最高.
