内容紹介
Summary
Background: Palliative care delivered to cancer patients late in the course of disease are inadequate to improve advance care planning and quality of life; thus, early palliative care is recommended. We retrospectively analyzed early palliative care delivered to patients with gastric cancer. Method: Forty-nine gastric cancer patients who underwent surgery and had received interdisciplinary care from the first visit(early palliative care)were assessed for physical and psychosocial symptoms. Results: All patients were followed up continuously by a nurse certified in palliative care support to provide quality patient-centered care from the beginning(advance care planning). Four patients had experienced relapse, and 3 older patients had decided not to receive chemotherapy following their advance care planning. However, all 4 patients were admitted to a palliative care unit without barriers. Conclusion: Early palliative care might lead patients to have advance care planning, and a better quality of life.
要旨
背景: がんと診断された時からの緩和ケアの推進は重要であり,がん対策基本法でも重点課題とされている。今回われわれは,緩和ケア介入(早期緩和ケア介入)をした胃癌症例の検討を後方視的に行った。対象と方法: 2015年4月～2018年3月までに当院で早期緩和ケア介入を行った胃癌手術患者49例を対象とし,治療経過の検討,患者の心配・苦痛の解析を後方視的に行った。結果: 患者自身の価値観や意向に沿った治療決定(advance care planning)ができるように緩和ケア認定看護師によって初診時から継続して支援を行った。再発は4例に認められたが,うち高齢である3例は化学療法を行わない決定や,自宅生活が困難になった段階の緩和ケア病棟への入院決定は障壁なく速やかに行うことができた。結論: 早期緩和ケア介入を行うことで患者の価値観,意向に沿ったadvance care planningを行い,円滑に治療を進めることができた。
目次
Background: Palliative care delivered to cancer patients late in the course of disease are inadequate to improve advance care planning and quality of life; thus, early palliative care is recommended. We retrospectively analyzed early palliative care delivered to patients with gastric cancer. Method: Forty-nine gastric cancer patients who underwent surgery and had received interdisciplinary care from the first visit(early palliative care)were assessed for physical and psychosocial symptoms. Results: All patients were followed up continuously by a nurse certified in palliative care support to provide quality patient-centered care from the beginning(advance care planning). Four patients had experienced relapse, and 3 older patients had decided not to receive chemotherapy following their advance care planning. However, all 4 patients were admitted to a palliative care unit without barriers. Conclusion: Early palliative care might lead patients to have advance care planning, and a better quality of life.
要旨
背景: がんと診断された時からの緩和ケアの推進は重要であり,がん対策基本法でも重点課題とされている。今回われわれは,緩和ケア介入(早期緩和ケア介入)をした胃癌症例の検討を後方視的に行った。対象と方法: 2015年4月～2018年3月までに当院で早期緩和ケア介入を行った胃癌手術患者49例を対象とし,治療経過の検討,患者の心配・苦痛の解析を後方視的に行った。結果: 患者自身の価値観や意向に沿った治療決定(advance care planning)ができるように緩和ケア認定看護師によって初診時から継続して支援を行った。再発は4例に認められたが,うち高齢である3例は化学療法を行わない決定や,自宅生活が困難になった段階の緩和ケア病棟への入院決定は障壁なく速やかに行うことができた。結論: 早期緩和ケア介入を行うことで患者の価値観,意向に沿ったadvance care planningを行い,円滑に治療を進めることができた。