Symptom Assessment and Early Access to Supportive and Palliative Care for Patients With Advanced Solid Tumors in Mexico
Autor: | Enrique Soto-Perez-de-Celis, Paul E. Goss, María Luisa Moreno-García, Wendy Alicia Ramos-Lopez, Paulina Quiroz-Friedman, Alfredo Covarrubias-Gómez, Sergio Contreras-Garduño, Mirza Jacqueline Alcalde-Castro, Africa Navarro-Lara, Yanin Chavarri-Guerra, Viridiana Perez-Montessoro, Sofía Sánchez-Román |
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Rok vydání: | 2019 |
Předmět: |
Male
Advance care planning medicine.medical_specialty Palliative care Developing country Symptom assessment Quality of life (healthcare) Neoplasms Surveys and Questionnaires medicine Humans Intensive care medicine Mexico Aged Retrospective Studies business.industry Patient Selection Palliative Care Social Support General Medicine Middle Aged Advanced cancer Practice Guidelines as Topic Female Symptom Assessment business |
Zdroj: | Journal of Palliative Care. 35:40-45 |
ISSN: | 2369-5293 0825-8597 |
Popis: | Background: Early specialized palliative care improves quality of life of patients with advanced cancer, and guidelines encourage its integration into standard oncology care. However, many patients fail to obtain timely palliative/supportive care evaluations, particularly in limited-resource settings. We aimed to determine the proportion of patients with advanced cancer who received an assessment of symptoms and were referred to supportive and palliative care services during the first year after diagnosis in a Mexican hospital. Methods: Individuals with newly diagnosed advanced solid tumors and 1 year of follow-up at the oncology clinics in the Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran in Mexico City from October 2015 to April 2016 were included in this retrospective study. Results: Seventy-seven patients were included. Forty-two (54.5%) were referred to the various supportive care services during the first year after diagnosis, and 23 (29.8%) were referred to the palliative care clinic. The most commonly assessed symptoms by oncologists were pain (77.9%), anorexia (74.0%), fatigue (68.8%), and nausea (55.8%), while depression/anxiety were evaluated in 10 (12.9%) patients. The oncologist offered to clarify treatment goals in 39 (50.6%) cases and evaluated the understanding of diagnosis/illness and prognosis in 22 (28.5%). Conclusion: Palliative and supportive care services were widely underutilized, which may be related to a lack of standardized symptom assessments and poor end-of-life communication. Novel strategies are needed to improve the implementation of tools for systematic symptom assessment and to optimize the integration of supportive care interventions into oncology care in developing countries. |
Databáze: | OpenAIRE |
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