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首页> 外文期刊>The journals of gerontology.Series A. Biological sciences and medical sciences >Patient age, well-being, perspectives, and care practices in the early treatment phase for late-stage cancer.
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Patient age, well-being, perspectives, and care practices in the early treatment phase for late-stage cancer.

机译：晚期癌症早期治疗阶段的患者年龄，健康状况，观点和护理实践。

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BACKGROUND: Among advanced-stage cancer patients, age is an important determinant of decision making about medical care. We examined age-related differences in patient well-being, care perspectives, and preferences, and the relationship between these patient characteristics and subsequent care practices including care communication, pain management, and acute care utilization during the early treatment phase of late-stage cancer. METHODS: Patient demographics, well-being, and care perspectives were assessed during patient and physician baseline interviews. Care practices were measured using outpatient and inpatient records for the 30-day period after baseline assessment. Multivariate regression models were used to examine the patterns of association of age and other patient characteristics with care practices. RESULTS: A total of 174 middle-aged and 149 older patients with recently diagnosed late-stage cancer were included. Older patients had more comorbidities but lower levels of depression, anxiety, and symptom distress. Older patients preferred pain relief/comfort as a treatment goal, but received fewer prescriptions for opioids. Whereas provider-initiated communication with patients/families was positively associated with severity of illness, patient/family-initiated communication was associated with patient psychosocial attributes and care perspectives. Satisfaction with care was inversely associated with reports of pain. Symptom distress was positively associated with subsequent opioid prescriptions and hospitalizations. CONCLUSIONS: Our results help to explain the role of patients' psychosocial attributes, care perspectives, and preferences in subsequent care practices during the early treatment phase for late-stage cancer. Age-related differences in patient well-being and care perspectives suggest a role for age-sensitive interventions in the treatment of advanced cancer patients.
机译：背景：在晚期癌症患者中，年龄是决定医疗决策的重要决定因素。我们研究了与年龄相关的患者幸福感，护理观点和偏好的差​​异，以及这些患者特征与后续护理实践之间的关系，包括晚期癌症早期治疗阶段的护理沟通，疼痛管理和急性护理利用率。方法：在患者和医师基线访谈期间评估了患者的人口统计学，幸福感和护理观点。在基线评估后的30天内，使用门诊和住院记录记录了护理实践。使用多元回归模型来检查年龄和其他患者特征与护理实践之间的关联模式。结果：总共纳入了174名最近诊断为晚期癌症的中年和149名老年患者。老年患者合并症较多，但抑郁，焦虑和症状困扰程度较低。老年患者更喜欢缓解疼痛/舒适感作为治疗目标，但接受阿片类药物的处方较少。由提供者发起的与患者/家人的沟通与疾病的严重程度呈正相关，而由患者/家庭发起的沟通与患者的心理社会属性和护理观点相关。护理满意度与疼痛报告呈负相关。症状困扰与随后的阿片类药物处方和住院治疗呈正相关。结论：我们的结果有助于解释晚期癌症早期治疗阶段患者的心理社会属性，护理观点和偏好在后续护理实践中的作用。患者的幸福感和护理观点与年龄相关的差异表明，年龄敏感性干预措施在晚期癌症患者的治疗中具有重要作用。

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