背景:在实践中长期建议晚期癌症患者接受姑息治疗(PC)以改善生活质量,心情,和延长生存期。然而,卵巢癌女性的PC转诊仍不理想。
目的:整合现有关于晚期卵巢癌女性患者PC转诊相关多种因素的文献,以更好地理解PC转诊和接受PC的背景因素,使用社会生态学模型。
方法:对科学数据库进行了搜索,包括PubMed,Embase,CINAHL完成,和PsycINFO。主要搜索词包括“卵巢癌”和“姑息治疗”,”,后来细化到包括晚期诊断。审查的文章包括对晚期卵巢癌的关注和报道的人口统计学,医疗/临床,支持,或在PC转诊过程中检查的系统级因素。
结果:13篇文章关注与PC转诊直接相关的因素。因素分为不同的社会生态水平:肿瘤水平,内心,人际关系,和环境。因素包括肿瘤特征,年龄,婚姻状况,医疗状况,性能状态,社会心理状况,支持系统,提供者,和基础设施。患者的医疗状况是PC转诊和护理过渡中考虑的主要因素。
结论:社会生态学框架中的各种因素表明,PC转诊的决定可能是多因素的,并受医疗状况和状况以外的因素的影响。未来的研究应旨在了解各种社会生态因素对PC转诊的影响,并从患者的角度检查PC转诊经验。
BACKGROUND: Receipt of palliative care (PC) has long been suggested in practice for patients with advanced cancer for improved quality of life, mood, and prolonged survival. However, PC referrals in women with ovarian cancer remain suboptimal.
OBJECTIVE: To consolidate existing literature on the multiple factors associated with PC referrals in women with advanced ovarian cancer and to better understand the contextual factors of PC referrals and frame receipt of PC using a socioecological model.
METHODS: A search of scientific databases was conducted, including PubMed, Embase, CINAHL Complete, and PsycINFO. Key search terms included \"ovarian cancer\" and \"palliative care,\" and later refined to include advanced stages of the diagnosis. The reviewed articles included a focus on advanced ovarian cancer and reported demographic, medical/clinical, support, or system-level factors examined in the PC referral process.
RESULTS: Thirteen articles focused on the factors directly associated with PC referrals. Factors were categorized into different socioecological levels: tumor-level, intrapersonal, interpersonal, and environmental. Factors included tumor characteristics, age, marital status, medical condition, performance status, psychosocial status, support system, provider, and infrastructure. The patient\'s medical condition was the major component considered in PC referral and care transition.
CONCLUSIONS: Various factors in the socioecological framework suggest that the decision for PC referral could be multifactorial and influenced by factors beyond the medical condition and status. Future research should aim to understand the impact of various socioecological factors on PC referral and examine PC referral experiences from the patient\'s perspective.