Older patients' experiences of treatment for colorectal cancer: an analysis of functional status and service use
Older patients' experiences of treatment for colorectal cancer: an analysis of functional status and service use
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DOI：
10.1111/j.1365-2354.2004.00555.x
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发表时间：
2004-12-01
影响因子：
2.1
通讯作者：
Haviland, J
中科院分区：
文献类型：
--
作者：
Bailey, C;Corner, J;Haviland, J
年龄和老龄化是癌症患者护理和治疗背景的重要组成部分。需要更多关于癌症治疗对住院护理后老年人生活的影响的信息。我们进行了一项为期 3 年的研究，其中患有结直肠癌的老年人在选择性治疗之前和之后完成了有关多维功能和服务使用的详细调查问卷。在这里，我们对治疗前后的功能状态和服务使用的变化进行了分析，并详细描述了老年人在治疗前后的经历。总计 337 名年龄 58-95 岁的结直肠腺癌患者在治疗前接受了 OARS 多维功能评估问卷 (OMFAQ)、鹿特丹症状检查表 (RSCL) 和发病严重程度评分的访谈。研究终点定义为治疗后功能状态、症状困扰、发病严重程度和服务使用频率。使用匹配分析比较治疗前和治疗后的数据。使用逻辑回归来评估年龄和主要结果指标之间的关联，并使用 chi(2) 检验比较不同年龄组之间治疗后的服务使用频率。总体而言，患者在治疗后经历了积极和消极的结果。值得注意的是，年龄大于或等于 75 岁的患者仅在一项主要结果指标上表现出改善。治疗后的服务使用模式表明，家庭支持是患者的一个关键问题。然而，除了护理服务外，大多数情况下，家庭帮助都是由家庭自己提供的。这就提出了一个重要问题：患者和家属在癌症治疗后出院之前接受或想要做多少准备。在住院护理后的几个月内，需要采取以家庭为中心的协作方法来满足人们的需求。
Age and ageing are an important part of the context within which the care and treatment of people with cancer is provided. More information is needed about the effects of cancer treatment on the lives of older people following inpatient care. We conducted a 3-year study in which older people with colorectal cancer completed a detailed questionnaire on multidimensional function and service use before and after elective treatment. Here we present an analysis of changes in functional status and service use over the pre- to post-treatment period, and set out a detailed picture of older people's experiences before and after treatment. In total, 337 patients with colorectal adenocarcinoma aged 58-95 years were interviewed before treatment using the OARS Multidimensional Functional Assessment Questionnaire (OMFAQ), Rotterdam Symptom Checklist (RSCL) and a severity of morbidity score. Study end points were defined as post-treatment functional status, symptom distress, severity of morbidity and frequency of service use. Pre- and post-treatment data were compared using matched analyses. Logistic regression was used to assess associations between age and the main outcome measures, and frequency of service use after treatment was compared between age groups using the chi(2) test. Overall, patients experienced both positive and negative outcomes following treatment. It was notable that patients aged greater than or equal to75 years showed improvement in only one of the principal outcome measures. Patterns of service use following treatment suggest that support at home is a key issue for patients. With the exception of nursing care, however, help at home is provided on a majority of occasions by families themselves. This raises important questions about how much preparation patients and families receive or would like before they leave hospital after treatment for cancer. A collaborative, family-centred approach to meeting people's needs is called for in the months following inpatient care.