Palliative care outcomes in surgical oncology patients with advanced malignancies: a mixed methods approach.
Qual Life Res
; 21(3): 405-15, 2012 Apr.
Article
em En
| MEDLINE
| ID: mdl-22101861
ABSTRACT
PURPOSE:
To prospectively compare outcomes and processes of hospital-based early palliative care with standard care in surgical oncology patients (N = 152).METHODS:
A randomized, mixed methods, longitudinal study evaluated the effectiveness of a hospital-based Pain and Palliative Care Service (PPCS). Interviews were conducted presurgically and at follow-up visits up to 1 year. Primary outcome measures included the Gracely Pain Intensity and Unpleasantness Scales and the Symptom Distress Scale. Qualitative interviews assessed social support, satisfaction with care, and communication with providers. Survival analysis methods explored factors related to treatment crossover and study discontinuation. Models for repeated measures within subjects over time explored treatment and covariate effects on patient-reported pain and symptom distress.RESULTS:
None of the estimated differences achieved statistical significance; however, for those who remained on study for 12 months, the PPCS group performed better than their standard of care counterparts. Patients identified consistent communication, emotional support, and pain and symptom management as positive contributions delivered by the PPCS.CONCLUSIONS:
It is unclear whether lower pain perceptions despite greater symptom distress were clinically meaningful; however, when coupled with the patients' perceptions of their increased resources and alternatives for pain control, one begins to see the value of an integrated PPCS.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Avaliação de Processos e Resultados em Cuidados de Saúde
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Cuidados Paliativos
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Qualidade de Vida
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Inquéritos e Questionários
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Oncologia
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Neoplasias
Tipo de estudo:
Clinical_trials
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Observational_studies
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Prognostic_studies
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Qualitative_research
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article