背景:晚期癌症患者的姑息治疗可以改善患者的症状,和生活质量(QoL)。然而,在晚期癌症住院患者中,通过专业姑息治疗咨询常规实施姑息治疗的需求仍未得到满足.我们的研究目的是与医学肿瘤学家的常规实践相比,评估基于团队的方法对QoL和再入院率的有效性。
方法:这项研究是一项前瞻性的,准实验设计。晚期癌症住院患者被非随机分配接受姑息治疗服务,由基于团队的方法或仅医学肿瘤学家。主要终点是QoL。次要终点是出院后7天和30天的再入院率。
结果:纳入了122名住院患者。通过基于团队的方法评估的住院患者与另一组相比,主观幸福感(SWB)的变化得分显着提高(ΔSWB:-1[-19-11]vs0[-9-15],p值=0.043)。此外,在基于团队的方法下进行评估的患者在出院7天时的再入院率显着降低(基于团队的方法组的4.92%与19.67%的医学肿瘤学家组,p值=0.013)。
结论:跨学科合作是成功建立护理目标的关键,它们支持尽可能好的QoL并缓解晚期癌症住院患者的痛苦症状。此外,通过以团队为基础的方法,出院7天时的再入院率显著降低.因此,需要通过跨专业合作实践进行全面的姑息治疗评估。
背景:泰国临床试验注册(TCTR):编号20200312001。首次注册日期:2020年9月3日。
BACKGROUND: Palliative care for patients with advanced cancer improves suffering symptoms, and quality of life (QoL). However, routine implementation of palliative care by specialty palliative care consultation is still an unmet need among in-patients with advanced cancer. Our study aim is to evaluate the effectiveness of a team-based approach on QoLs and readmission rate when compared to routine practice by among medical oncologists.
METHODS: This study was a prospective, Quasi-Experimental design. In-patients with advanced cancer were non-randomly assigned to receive palliative care service by team-based approach or medical oncologists only. The primary endpoint was QoL. The secondary endpoint was the readmission rate at 7 and 30 days of hospital discharge.
RESULTS: One hundred twenty-two in-patients were enrolled. In-patients who were assessed by a team-based approach had significantly improved change scores of subjective well-being (SWB) when compared to another group (∆ SWB: -1 [-19 - 11] vs 0 [-9 - 15], p-value = 0.043). Furthermore, patients who were assessed under a team-based approach had significantly decreased in terms of readmission rate at 7 days of hospital discharge (4.92% in the team-based approach group vs. 19.67% in the medical oncologist group, p-value = 0.013).
CONCLUSIONS: Interdisciplinary collaboration is the key to success in establishing goals of care, which are supporting the best possible QoL and relieving suffering symptoms for those in-patients with advanced cancer. Furthermore, the readmission rate at 7 days of hospital discharge was significantly reduced by a team-based approach. Therefore, comprehensive palliative care assessment by interprofessional collaborative practice is required.
BACKGROUND: Thai Clinical Trials Registry (TCTR): number 20200312001. Date of first registration on 09/03/2020.