Adaptation of Serious Illness Care Program to be delivered via telehealth for older patients with hematologic malignancy.
Adaptation of Serious Illness Care Program to be delivered via telehealth for older patients with hematologic malignancy.
复制标题
DOI：
10.1182/bloodadvances.2022008996
复制
发表时间：
2023-05-09
期刊：
影响因子：
7.5
通讯作者：
Loh, Kah Poh
中科院分区：
文献类型：
--
作者：
LoCastro, Marissa;Sanapala, Chandrika;Mendler, Jason H.;Norton, Sally;Bernacki, Rachelle;Carroll, Thomas;Klepin, Heidi D.;Watson, Erin;Liesveld, Jane;Huselton, Eric;O'Dwyer, Kristen;Baran, Andrea;Flannery, Marie;Kluger, Benzi;Loh, Kah Poh
我们对一种严重疾病照护计划（SICP）进行了调整，以便通过远程医疗为患有血液系统恶性肿瘤的老年人提供服务。
调整后的SICP可能有助于更早地开展预先护理计划讨论。
患有急性髓系白血病（AML）和骨髓增生异常综合征（MDS）的老年患者在生命末期会经历高强度的住院医疗护理。早期的预先护理计划可能会改善AML或MDS患者生命末期的护理。严重疾病照护计划（SICP）是一种多成分的沟通干预措施，旨在改善重症患者关于自身价值观的交流。SICP已被证明可以提高预先护理计划讨论的质量和频率。我们针对AML或MDS老年患者对SICP进行了调整，使其能够通过远程医疗提供服务。我们对45名参与者（25名临床医生、15名患有AML或MDS的老年患者以及5名护理人员）进行了单中心定性研究。参与者，无论是临床医生、患者还是护理人员，都一致认为SICP将有助于患有AML或MDS的老年患者与他们的护理团队分享个人价值观。从我们的数据中出现了四个定性主题：（1）严重疾病相关的交流可以通过远程医疗进行；（2）老年患者使用技术的经验有限，但愿意且能够学习；（3）患者认为严重疾病相关的交流将帮助他们更好地理解自己的AML或MDS诊断和预后；（4）严重疾病相关的交流应该是常见和常规的，而不是特殊的。调整后的SICP可能为患有AML或MDS的老年患者提供一个机会，让他们能够与护理团队分享对自己最重要的事情，并可能帮助肿瘤医生使患者护理与患者价值观相一致。调整后的SICP是威尔莫特癌症研究所正在进行的一项单臂试点研究的对象（临床试验注册号：NCT04745676）
We adapted an SICP to be delivered via telehealth for older adults with hematologic malignancies. The adapted SICP may facilitate earlier advance care planning discussions. Older patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) experience intense inpatient health care at the end-of-life stage. Early advance care planning may improve care at the end of life for patients with AML or MDS. The Serious Illness Care Program (SICP) is a multicomponent, communication intervention developed to improve conversations about values for patients with serious illnesses. The SICP has been shown to improve the quality and frequency of advance care planning discussions. We adapted the SICP for delivery via telehealth to older patients with AML or MDS. We conducted a single-center qualitative study of 45 participants (25 clinicians, 15 older patients with AML or MDS, and 5 caregivers). Participants, whether clinicians, patients, or caregivers, agreed that the SICP would help older patients with AML or MDS to share their personal values with their care team. Four qualitative themes emerged from our data: (1) serious illness conversations can be conducted via telehealth, (2) older patients have limited experience using technology but are willing and able to learn, (3) patients feel that serious illness conversations will help them understand their AML or MDS diagnosis and prognosis better, and (4) serious illness conversations should be common and routine, not extraordinary. The adapted SICP may provide older patients with AML or MDS an opportunity to share what matters most to them with their care team and may assist oncologists in aligning patient care with patient values. The adapted SICP is the subject of an ongoing single-arm pilot study at the Wilmot Cancer Institute (clinicaltrials.gov identifier: NCT04745676).
登录
查看更多内容
影响因子：
4.7
作者：
Abdallah M;Xie Z;Ready A;Manogna D;Mendler JH;Loh KP
通讯作者：
Loh KP
影响因子：
2.9
作者：
Bernacki R;Hutchings M;Vick J;Smith G;Paladino J;Lipsitz S;Gawande AA;Block SD
通讯作者：
Block SD
影响因子：
3.5
作者：
Ftouni, Racha;AlJardali, Baraa;Hamdanieh, Maya;Ftouni, Louna;Salem, Nariman
通讯作者：
Salem, Nariman
影响因子：
6.2
作者：
Alibhai, Shabbir M. H.;Leach, Marc;Brandwein, Joseph
通讯作者：
Brandwein, Joseph
影响因子：
2.2
作者：
Agarwal R;Epstein AS
通讯作者：
Epstein AS