Assessing the need for a question prompt list that encourages end-of-life discussions between patients with advanced cancer and their physicians: A focus group interview study
Assessing the need for a question prompt list that encourages end-of-life discussions between patients with advanced cancer and their physicians: A focus group interview study
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评估鼓励晚期癌症患者与其医生进行临终讨论的问题提示列表的必要性：焦点小组访谈研究
DOI：
10.1017/s1478951521001796
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发表时间：
2022
影响因子：
2.2
通讯作者：
Uchitomi Yosuke
中科院分区：
文献类型：
--
作者：
Sato Ayako;Fujimori Maiko;Shirai Yuki;Umezawa Shino;Mori Masanori;Jinno Sayaka;Umehashi Mihoto;Okamura Masako;Okusaka Takuji;Majima Yoshiyuki;Miyake Satoshi;Uchitomi Yosuke
目的 姑息治疗和癌症治疗的早期整合提高了生活质量，并通过晚期癌症患者与其医生之间关于停止积极癌症治疗后生命结束的讨论来促进。然而，患者和医生都发现生命结束的讨论具有挑战性。本研究的目的是评估是否需要一个问题提示列表（QPL），鼓励晚期癌症患者和他们的医生之间的临终讨论。方法 焦点小组访谈（FGI）进行了18名参与者，其中包括5名胰腺癌患者，3名家庭照顾者，4名丧亲家庭成员和6名医生。讨论了三个主题：QPL中应包含的问题项目，鼓励在停止积极的癌症治疗后与患者、家庭护理人员和医生进行临终讨论;何时应提供QPL;以及谁应提供QPL。每次访谈都进行了录音，并进行了内容分析。结果 以下9个类别，57个问题项目，从功能性地理标志中产生：（1）为生命结束做准备，（2）治疗决策，（3）当前和未来的生活质量，（4）当前和未来的症状管理，（5）过渡到姑息治疗服务的信息，（6）应对癌症，（7）照顾者的作用，（8）心理护理，及（9）癌症护理的连续性。参与者认为，负责患者护理的医生和其他医务人员应在积极的癌症治疗期间尽早提供QPL。结果的意义 收集数据以制定QPL，鼓励晚期癌症患者与其医生之间的临终讨论。
Objective Early integration of palliative and cancer care improves the quality of life and is facilitated by discussions about the end of life after cessation of active cancer treatment between patients with advanced cancer and their physicians. However, both patients and physicians find end-of-life discussions challenging. The aim of this study was to assess the need for a question prompt list (QPL) that encourages end-of-life discussions between patients with advanced cancer and their physicians. Methods Focus group interviews (FGIs) were conducted with 18 participants comprising 5 pancreatic cancer patients, 3 family caregivers, 4 bereaved family members, and 6 physicians. Three themes were discussed: question items that should be included in the QPL that encourages end-of-life discussions with patients, family caregivers, and physicians after cessation of active cancer treatment; when the QPL should be provided; and who should provide the QPL. Each interview was audio-recorded, and content analysis was performed. Results The following 9 categories, with 57 question items, emerged from the FGIs: (1) preparing for the end of life, (2) treatment decision-making, (3) current and future quality of life, (4) current and future symptom management, (5) information on the transition to palliative care services, (6) coping with cancer, (7) caregivers’ role, (8) psychological care, and (9) continuity of cancer care. Participants felt that the physician in charge of the patient's care and other medical staff should provide the QPL early during active cancer treatment. Significance of results Data were collected to develop a QPL that encourages end-of-life discussions between patients with advanced cancer and their physicians.