Kanser tanılı hastalarda palyatif bakım hizmetlerinin etkisinin değerlendirilmesi: Semptom düzeyi ve bakım memnuniyeti açısından bir karşılaştırma

Amaç: Bu çalışmanın amacı, kanser tanılı hastalarda palyatif bakım hizmeti almanın, semptom ve memnuniyet düzeyine etkisini değerlendirmektir. Gereç ve Yöntem: Bu araştırma, Palyatif Bakım Merkezi’nde (PBM) hizmet alan 60 ve kamu hastanesinde genel bakım hizmeti alan 59 kanser tanılı hastayla gerçekleştirildi. İki farklı hastanede sunulan hizmetlerin etkisini değerlendirmede; Edmonton Semptom Tanılama Ölçeği ve Avrupa Kanser Tedavisi ve Araştırmaları Organizasyonu Bakım Memnuniyet Ölçeği (EORTC-INPATSAT32) kullanıldı. Veriler, SPSS ve Excel programları kullanılarak; sayı ve yüzde dağılımları, iki eş arasındaki farkın önemlilik testi ve tekrarlı ölçümlerde iki yönlü varyans analizi yöntemleriyle analiz edildi. Bulgular: PBM’de hizmet alan hastaların semptom şiddetlerinin, daha yüksek olduğu belirlendi. Bir hafta ara ile gerçekleştirilen semptom değerlendirilmesinde, hastaneler arasında “yorgunluk, bulantı ve solunum güçlüğü” semptomları açısından istatistiksel olarak anlamlı bir fark olduğu (p

An evaluation of palliative care service effect in patients with cancer diagnosis: Comparison in terms of the symptom level and care satisfaction

Objectives: The aim of this study was to evaluate the effect of palliative care on the symptom level assessment and satisfaction of patients diagnosed with cancer. Methods: The study was carried out with 60 cancer patients who received service at a palliative care center (PCC) and 59 cancer patients who received general care services at a public hospital. The effect of the services provided at the 2 hospitals was evaluated using the Edmonton Symptom Assessment System and the European Organisation for Research and Treatment of Cancer In-patient Satisfaction with Care Questionnaire. The data were analyzed to determine number and percentage distributions, the significance of differences between 2 peers, and 2-way analysis of variance in repetitive measurements. Results: It was determined that the symptom severity of the PCC patients was greater. In a 1 week interval, greater improvement was observed in all of the symptoms of the patients who received general care, and the evaluation revealed a statistically significant difference between the hospitals in terms of fatigue, nausea, and dyspnea (p

PDF

___

1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68(6):394–424.
2. Boyle P. Levin B. World cancer report 2008. Lyon, France: International Agency for Research on Cancer; 2008. p. 76–81.
3. Şencan İ. Keskinkiliç B. Turkey cancer statistics 2014. Ankara, Turkey: Sağlık Bakanlığı, Türkiye Halk Sağlığı Kurumu; 2017. p. 36–44.
4. World Health Organization. Cancer Control: Knowledge İnto Action: WHO Guide For Effective Programmes. Geneva, Switzerland; World Health Organization; 2007. p. 2–15.
5. World Health Organization. Global atlas of palliative care at the end of life. Geneva, Switzerland; World Health Organization; 2014. p. 4–9.
6. Hatziandreu E, Archontakis F, Daly A. The potential cost savings of greater use of home- and hospice based end of life care in England. London: RAND. 2008.
7. Nickolich MS, El-Jawahri A, Temel JS, LeBlanc TW. Discussing the Evidence for Upstream Palliative Care in Improving Outcomes in Advanced Cancer. Am Soc Clin Oncol Educ Book 2016;35:e534–8.
8. Zambrano SC, Fliedner MC, Eychmüller S. The impact of early palliative care on the quality of care during the last days of life: what does the evidence say? Curr Opin Support Palliat Care 2016;10(4):310–5.
9. Draper M, Cohen P, Buchan H. Seeking consumer views: what use are results of hospital patient satisfaction surveys? Int J Qual Health Care 2001;13(6):463–8.
10. Brédart A, Coens C, Aaronson N, Chie WC, Efficace F, Conroy T, et al; EORTC Quality of Life Group and EORTC Quality of Life Unit. Determinants of patient satisfaction in oncology settings from European and Asian countries: preliminary results based on the EORTC IN-PATSAT32 questionnaire. Eur J Cancer 2007;43(2):323–30.
11. Etkind SN, Bone AE, Gomes B, Lovell N, Evans CJ, Higginson IJ, et al. How many people will need palliative care in 2040? Past trends, future projections and implications for services. BMC Med 2017;15(1):102.
12. Ozgul N, Gultekin M, Koc O, Goksel F, Bayraktar G, Ekinci H, et al. Turkish community-based palliative care model: a unique design. Ann Oncol 2012;23 Suppl 3:76–8.
13. Dieter Haussmann RK, Hegyvary ST, Newman JF, Bishop AC. Monitoring quality of nursing care. Health Serv Res 1974;9(2):135–48.
14. Zaybak A, Güneş ÜY, İsmailoğlu EG, Ülker E. Yatağa Bağımlı Hastalara Bakım Veren Bireylerin Bakım Yüklerinin Belirlenmesi. J Anatolia Nurs Health Sci 2012;15(1):48–54.
15. Bruera E, Hui D. Integrating supportive and palliative care in the trajectory of cancer: establishing goals and models of care. J Clin Oncol 2010;28(25):4013–7.
16. Sadırlı SK, Ünsar S. Edmonton Symptom Assessment Scale (ESAS) in Patients with Cancer: The Turkish Study of Validity and Reliability. Fırat Saglık Hizmetleri Dergisi 2009;4(11):79–95.
17. Brédart A, Bottomley A, Blazeby JM, Conroy T, Coens C, D’Haese S, et al; European Organisation for Research and Treatment of Cancer Quality of Life Group and Quality of Life Unit. An international prospective study of the EORTC cancer in-patient satisfaction with care measure (EORTC IN-PATSAT32). Eur J Cancer 2005;41(14):2120–31.
18. Krug K, Miksch A, Peters-Klimm F, Engeser P, Szecsenyi J. Correlation between patient quality of life in palliative care and burden of their family caregivers: a prospective observational cohort study. BMC Palliat Care 2016;15:4.
19. Ciemins EL, Blum L, Nunley M, Lasher A, Newman JM. The economic and clinical impact of an inpatient palliative care consultation service: a multifaceted approach. J Palliat Med 2007;10(6):1347–55.
20. Hanson LC, Usher B, Spragens L, Bernard S. Clinical and economic impact of palliative care consultation. J Pain Symptom Manage 2008;35(4):340–6.
21. Modonesi C, Scarpi E, Maltoni M, Derni S, Fabbri L, Martini F, Sansoni E, Amadori D. Impact of palliative care unit admission on symptom control evaluated by the edmonton symptom assessment system. J Pain Symptom Manage 2005;30(4):367–73.
22. Uysal N, Şenel G, Karaca Ş, Kadıoğulları N, Koçak N, Oğuz G. Palyatif bakım kliniğinde yatan hastalarda görülen semptomlar ve palyatif bakımın semptom kontrolüne etkisi. Agri 2015;27(2):104–10.
23. Leppert W, Majkowicz M, Forycka M, Mess E, ZdunRyzewska A. Quality of life assessment in advanced cancer patients treated at home, an inpatient unit, and a day care center. Onco Targets Ther 2014;7:687–95.
24. Chand P, Gabriel T, Wallace CL, Nelson CM. Inpatient palliative care consultation: describing patient satisfaction. Perm J 2013;17(1):53–5.
25. Pinto C, Firth AM, Groeneveld EI, Guo P, Sykes N, Murtagh FE. Patients’ views on care and their association with outcomes in palliative care. Palliat Med 2019;33(4):467–9.
26. Smallwood N, Moran T, Thompson M, Eastman P, Le B, Philip J. Integrated respiratory and palliative care leads to high levels of satisfaction: a survey of patients and carers. BMC Palliat Care 2019;18(1):7.
27. García AR. [Pesticides in the tropical agricultural economy systems: Evaluation of present knowledge of the problem]. [Article in Spanish] Rev Biol Trop 1976;24(1 Suppl):69–77.
28. Turriziani A, Attanasio G, Scarcella F, Sangalli L, Scopa A, Genualdo A, et al. The importance of measuring customer satisfaction in palliative care. Future Oncol 2016;12(6):807–13.
29. Hannon B, Swami N, Krzyzanowska MK, Leighl N, Rodin G, Le LW, et al. Satisfaction with oncology care among patients with advanced cancer and their caregivers. Qual Life Res 2013;22(9):2341–9.
30. DeRouen MC, Smith AW, Tao L, Bellizzi KM, Lynch CF, Parsons HM, et al; AYA HOPE Study Collaborative Group. Cancer-related information needs and cancer’s impact on control over life influence health-related quality of life among adolescents and young adults with cancer. Psychooncology 2015;24(9):1104–15.
31. Husson O, Mols F, van de Poll-Franse LV. The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: a systematic review. Ann Oncol 2011;22(4):761–72.
32. Aspinal F, Addington-Hall J, Hughes R, Higginson IJ. Using satisfaction to measure the quality of palliative care: a review of the literature. J Adv Nurs 2003;42(4):324–39.
33. Aboshaiqah A, Al-Saedi TS, Abu-Al-Ruyhaylah MM, Aloufi AA, Alharbi MO, Alharbi SS, et al. Quality of life and satisfaction with care among palliative cancer patients in Saudi Arabia. Palliat Support Care 2016;14(6):621–7.