背景:姑息治疗方案,其中包括疼痛管理,症状控制,社会心理支持和康复,旨在提高患者的生活质量,减轻非正式护理人员的负担和焦虑,并最终提供一种全面的方法来在这个充满挑战和敏感的时期提高福祉。这项研究旨在评估综合康复姑息治疗计划对晚期癌症患者及其非正式护理人员的生活质量的影响。
方法:这项准实验研究,2023年8月至2024年1月在曼苏拉大学肿瘤学中心附属门诊进行,埃及,专注于姑息治疗部门的癌症患者及其护理人员。采用前测试阶段和后测试阶段,数据是通过问卷调查收集的,EORTCQLQC30,医院焦虑和抑郁量表,简短形式的健康调查,照顾者负担库存,和贝克焦虑量表。调查评估了一项为期16周的康复计划,包括锻炼,心理教育,个人咨询,和精神支持。练习,在物理治疗师的带领下,通过量身定制的有氧和阻力训练有针对性的疲劳和压力。旨在增强应对能力的心理教育课程,涵盖疲劳管理和营养。训练有素的顾问解决了精神和存在的问题。个人咨询会议可供个人支持。护理人员接受了康复和姑息治疗方案的教育,确保全面的患者护理。
结果:癌症患者的平均年龄为65.79±13.85。相比之下,主要护理人员的平均年龄为42.05±11.15.癌症患者在测试前阶段的QOL为77.8±7.16,在测试后阶段上升至87.34±14.56。此外,在进行康复姑息治疗计划之前,患者的总焦虑水平为15.45±3.05,而在测试后阶段为6.12±3.21。此外,在测试前阶段,患者的总抑郁水平为20.89±9.21。然而,实施康复姑息治疗计划后,下降到15.5±6.86。关于非正式护理人员的总体生活质量,在进行该计划之前,它测得为67.28±32.09。然而,进行后增加到25.95±40.29。此外,实施该计划前的总照顾者负担清单为37.45±25.7,实施后下降为29.36±16.4。此外,贝克焦虑量表的总分从初始测试阶段的45.7±4.3降至17.35±23.67.
结论:康复姑息治疗计划通过提高癌症患者及其护理人员的整体生活质量,成功实现了其目标。此外,它降低了患者的焦虑和抑郁水平,以及护理人员的焦虑和护理人员负担。继续研究康复姑息治疗计划的有效性,以确定最佳做法,改进现有方案,并扩大对这些服务的访问。
BACKGROUND: Palliative care schemes, which include pain management, symptom control, psychosocial support and rehabilitation, aim to boost patients\' quality of life, ease the burden and anxiety of informal caregivers, and ultimately provide a comprehensive approach to enhance well-being during this challenging and sensitive period. This
study aims to evaluate the impact of a comprehensive rehabilitation palliative care program on the quality of life of patients with terminal cancer and their informal caregivers.
METHODS: This quasi-experimental
study, conducted from August 2023 to January 2024 at outpatient clinics affiliated with the Oncology Center at Mansoura University, Egypt, focused on cancer patients and their caregivers in the palliative care department. Employing pre- and post-test phases, data were gathered using a questionnaire, EORTC QLQ C30, Hospital Anxiety and Depression Scale, Short Form Health Survey, Caregiver Burden Inventory, and Beck Anxiety Inventory. The investigation evaluated a 16-week rehabilitation program comprising exercise, psychoeducation, individual counselling, and spiritual support. Exercises, led by a physiotherapist, targeted fatigue and stress through tailored aerobic and resistance training. Psychoeducation sessions aimed to bolster coping abilities, covering fatigue management and nutrition. Trained counsellors addressed spiritual and existential concerns. Personal advisory sessions were available for individual support. Caregivers received education on rehabilitation and palliative care protocols, ensuring comprehensive patient care.
RESULTS: The mean age for cancer patients was 65.79 ± 13.85. In contrast, the mean age for primary carers was 42.05 ± 11.15. The QOL for cancer patients during the pre-test phase was 77.8 ± 7.16 and rose to 87.34 ± 14.56 during the post-test phase. Additionally, the total anxiety level of patients before the rehabilitation palliative care program was conducted was 15.45 ± 3.05 compared to 6.12 ± 3.21 after the post test phase. Furthermore, the total depression levels of the patients during the pre-test phase were 20.89 ± 9.21. However, after implementing the rehabilitation palliative care program, it decreased to 15.5 ± 6.86. In regards to the total quality of life of informal caregivers, it was measured at 67.28 ± 32.09 before conducting the program. Nevertheless, it increased to 25.95 ± 40.29 after conducting it. Additionally, the total Caregiver Burden Inventory before implementing the program was 37.45 ± 25.7, and it decreased to 29.36 ± 16.4 after conducting it. Additionally, the total score on the Beck Anxiety Inventory decreased from 45.7 ± 4.3 during the initial testing phase to 17.35 ± 23.67.
CONCLUSIONS: The program for rehabilitation palliative care successfully achieved its goals by enhancing the overall quality of life for cancer patients and their caregivers. Additionally, it reduced the anxiety and depression levels among the patients, as well as the anxiety and caregiver burden among the caregivers. Continue research into the effectiveness of rehabilitation palliative care programs to identify best practices, improve existing programs, and expand access to these services.