Current status of integrating oncology and palliative care in Japan: a nationwide survey
Current status of integrating oncology and palliative care in Japan: a nationwide survey
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DOI：
10.1186/s12904-020-0515-5
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发表时间：
2020-01-24
影响因子：
3.1
通讯作者：
Muto, M.
中科院分区：
文献类型：
--
作者：
Uneno, Y.;Sato, K.;Muto, M.
背景 人们越来越认识到姑息治疗（PC）对于肿瘤治疗至关重要，一些学术协会强烈建议将肿瘤学和姑息治疗（IOP）纳入日常实践中。同样，日本政府通过 2007 年《癌症控制法》鼓励实施 IOP；然而，其具体进展仍不清楚。因此，本次全国范围的横断面调查旨在调查医院主治医师对眼压的现状和认知。方法根据国际共识的眼压指标制定调查问卷。于 2017 年 11 月将其分发给所有政府指定癌症医院（DCH，n = 399）的执行医生和匹配的非 DCH（n = 478），并对结果进行比较。结果 总共有 269 名（67.4%）DCH 和 259 名（54.2%）非 DCH 做出了回应。大家庭卫生院的 PC 资源数量显着高于非大家庭卫生院（例如，专职 PC 医生和护士，52.8% vs. 14.0%，p < 0.001；门诊 PC 服务的可用性每周 >= 3 天，47.6% vs. 20.7%，p < 0.001）。与非 DCH 相比，DCH 中进行常规症状筛查的频率更高（65.1% vs. 34.7%，p < 0.001）。 PC 转介可用性的自动触发受到限制（例如，使用时间触发的转介，14.9% 与 15.3%，p = 0.700）。这两类医院的教育和研究机会都受到严重限制。大多数执行医师认为 IOP 对患者有益（95.9% vs. 94.7%，p = 0.163），并愿意帮助患者尽早转诊至 PC 服务（54.7% vs. 60.0%，p < 0.569）；然而，大多数人面临增加全职 PC 员工数量的挑战，并且 < 30% 的人计划增加员工数量。结论 这项调查突显了相当多的 IOP 指标得到满足，特别是在大家庭住宅中，这可能是由于政府政策所致。需要进一步努力解决严重的研究/教育差距。
Background Palliative care (PC) is increasingly recognized as essential for oncology care, and several academic societies strongly recommend integrating oncology and palliative care (IOP) in daily practice. Similarly, the Japanese government encouraged the implementation of IOP through the Cancer Control Act of 2007; however, its detailed progress remains unclear. Therefore, this cross-sectional nationwide survey was conducted to investigate the current status and hospital executive physicians' perception of IOP. Methods The questionnaire was developed based on IOP indicators with international consensus. It was distributed to executive physicians at all government-designated cancer hospitals (DCHs, n = 399) and matched non-DCHs (n = 478) in November 2017 and the results were compared. Results In total, 269 (67.4%) DCHs and 259 (54.2%) non-DCHs responded. The number of PC resources in DCHs was significantly higher than those in non-DCHs (e.g., full-time PC physicians and nurses, 52.8% vs. 14.0%, p < 0.001; availability of outpatient PC service >= 3 days per week, 47.6% vs. 20.7%, p < 0.001). Routine symptom screening was more frequently performed in DCHs than in non-DCHs (65.1% vs. 34.7%, p < 0.001). Automatic trigger for PC referral availability was limited (e.g., referral using time trigger, 14.9% vs. 15.3%, p = 0.700). Education and research opportunities were seriously limited in both types of hospitals. Most executive physicians regarded IOP as beneficial for their patients (95.9% vs. 94.7%, p = 0.163) and were willing to facilitate an early referral to PC services (54.7% vs. 60.0%, p < 0.569); however, the majority faced challenges to increase the number of full-time PC staff, and < 30% were planning to increase the staff members. Conclusions This survey highlighted a considerable number of IOP indicators met, particularly in DCHs probably due to the government policy. Further efforts are needed to address the serious research/educational gaps.