多层次决定因素对晚期卵巢癌患者的姑息治疗转诊的影响:一项范围性综述。
Multilevel Determinants of Palliative Care Referral in Women with Advanced Ovarian Cancer: A Scoping Review.
发表日期:2023 Sep 17
作者:
Susie Cho, Barbara A Goff, Donna L Berry
来源:
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
摘要:
为了改善晚期癌症患者的生活质量、情绪和延长生存期,实践中长期以来一直推荐给予姑息治疗(PC)。然而,卵巢癌女性患者的PC转诊仍然不够理想。通过汇总现有的文献,研究与晚期卵巢癌女性患者的PC转诊相关的多种因素,更好地了解PC转诊的背景因素,并采用社会生态模型来界定PC的接受情况。本研究检索了包括PubMed、Embase、CINAHL Complete和PsycINFO在内的科学数据库。关键检索词包括“卵巢癌”和“姑息治疗”,后来进一步完善为包括晚期诊断在内的高级阶段。审查的文章主要关注晚期卵巢癌,并报告了影响PC转诊过程中的人口统计学、医学/临床、支持或系统层面因素。共有13篇文章专注于与PC转诊直接相关的因素。这些因素被分为不同的社会生态层次:肿瘤层次、个体层次、人际层次和环境层次。这些因素包括肿瘤特征、年龄、婚姻状况、医学状况、患者状态、心理社会状况、支持系统、提供者和基础设施。患者的医学状况是考虑PC转诊和护理过渡的主要因素。社会生态框架中的各种因素表明,PC转诊的决定可能是多因素的,并受到医学状况和身体状况之外的因素的影响。未来的研究应该旨在了解各种社会生态因素对PC转诊的影响,并从患者的角度研究PC转诊的经验。版权所有 © 2023年由Elsevier Inc.出版。
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.To consolidate existing literature on the multiple factors associated with PC referrals in women with advanced ovarian cancer to better understand the contextual factors of PC referrals and frame receipt of PC using a socioecological model.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.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.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.Copyright © 2023. Published by Elsevier Inc.