■超过50%的晚期癌症患者患有与癌症相关的恶病质(CC)-这是发病率和死亡率的主要原因。尽管乌干达缺乏关于CC诊断和管理的当地指南,美国临床肿瘤学会(ASCO),欧洲肿瘤医学学会(ESMO)和全球营养不良领导力倡议(GLIM)制定了CC筛查和管理指南.然而,乌干达肿瘤卫生专业人员对CC的知识水平和对现有指南的遵守情况尚不清楚.本研究旨在评估参与癌症患者护理的医疗保健专业人员(HCP)对CC诊断和管理的认识和知识水平,以及对ASCO/ESMO/GLIM关于CC指南的遵守情况。
■在第一阶段,使用ASCO/ESMO和GLIM关于CC诊断和管理的指南开发的自我管理的结构化问卷用于评估意识水平,以及来自三家医院的200名卫生专业人员在CC上的知识,并遵守ASCO/ESMO/GLIM关于CC相关核心沟通的指导方针,沟通障碍,临床医生沟通培训,讨论护理目标,治疗选择和满足服务不足人群的需求。将数据输入到使用STATA版本18.0软件分析的研究电子数据捕获软件中。
■CC诊断标准的总体客观正确知识得分为67.5%(n=135),然而,对于ASCO/ESMO/GLIM关于CC的指南的知晓率较低,为30%(n=60),只有21%(n=42)的HCP曾经评估过CC患者的生活质量.ASCO/ESMO/GLIM指南对CC患者营养干预的依从性在变量之间明显不同,对于特定的ASCO/ESMO/GLIM指南建议,从25.1%(n=50)到81%(n=162)不等。尽管遵守关于讨论护理目标的指导方针,预后,治疗选择和临终关怀在大多数变量中得分最高,大多数HCP在不治之症早期对患者临终偏好的讨论依从性较低(49.8%,n=99)。在遵守ASCO/ESMO/GLIM指南的情况下,三家医院中只有两个变量的平均得分之间存在统计学上的显着差异。
■这项研究表明,对CC诊断标准的总体客观正确知识不足,对ASCO/ESMO/GLIM关于CC的指南的认识水平要低得多,少数HCP曾经评估过CC患者的生活质量。对CC诊断和管理的质量改进干预措施应优先提高对CC的知识水平,诊断标准和患者-临床医生沟通,包括使用标准化工具(如ASCO/ESMO或GLIM指南)对患者临终关怀的讨论,使用多学科团队方法。
UNASSIGNED: More than 50% of people with advanced cancer suffer from cancer-related cachexia (CC) - a major contributor to morbidity and mortality. Despite the lack of local guidelines on CC diagnosis and management in Uganda, the American Society of Clinical Oncology (ASCO), the European Society for Medical Oncology (ESMO) and the Global Leadership Initiative on Malnutrition (GLIM) developed guidelines on CC screening and management. However, the level of knowledge on CC and compliance with the available guidelines among Ugandan oncology health professionals is unknown. This study aimed to assess the level of awareness and knowledge of CC diagnosis and management and compliance with the ASCO/ESMO/GLIM guidelines on CC among healthcare professionals (HCPs) involved in the care of cancer patients.
UNASSIGNED: In this phase one, a self-administered structured questionnaire developed using the ASCO/ESMO and GLIM guidelines on diagnosis and management of CC was used to assess the level of awareness, and knowledge of 200 health professionals from three hospital settings on CC, and compliance with the ASCO/ESMO/GLIM guidelines on CC related core communication, barriers to communication, clinician training in communication, discussing goals of care, treatment options and meeting the needs of the underserved populations. The data were entered into Research Electronic Data Capture software analysed using STATA version 18.0 software.
UNASSIGNED: The overall objectively correct knowledge score of CC diagnosis criteria was 67.5% (n = 135), yet there was a much lower level of awareness about ASCO/ESMO/GLIM guidelines on CC at 30% (n = 60) and only 21% (n = 42) of the HCPs have ever assessed Quality of life of CC patients. The compliance with ASCO/ESMO/GLIM guidelines on nutritional interventions for patients with CC varied across the variables markedly, ranging from 25.1% (n = 50) to 81% (n = 162) for the specific ASCO/ESMO/GLIM guidelines\' recommendations. Whereas compliance with the guidelines on discussing goals of care, prognosis, treatment options and end-of-life care scored the highest in most variables, most HCPs exhibited low compliance with the discussion about patients\' end-of-life preferences early in the course of incurable illness (49.8%, n = 99). There were statistically significant differences between the mean scores of only two variables among the three hospitals in compliance with ASCO/ESMO/GLIM guidelines on the provision.
UNASSIGNED: This study indicated that the overall objectively correct knowledge of CC diagnosis criteria was inadequate, with a much lower level of awareness about the ASCO/ESMO/GLIM guidelines on CC and a handful of the HCPs have ever assessed the quality of life of CC patients. Quality improvement interventions on CC diagnosis and management should prioritize improving the level of knowledge on CC, diagnostic criteria and patient-clinician communication, including discussion about patients\' end-of-life care using standardised tools such as ASCO/ESMO or GLIM guidelines on CC using a multidisciplinary team approach.