Evaluation of Palliative Care Needs of Advanced Stage Cancer Patients Admitting to the Emergency Department

Öz

Objective: This study aimed to evaluate the palliative care needs of advanced stage cancer patients who applied to the emergency department. Material and Method: The research is descriptive and was conducted with 159 patients who met the selection criteria in the emergency departments of three public hospitals in Istanbul. The data for the study was collected using three tools: the Patient Information Questionnaire Form, the Palliative Performance Scale (PPS), and the Quality of Life in Palliative Cancer Care Patients (EORTC-QLQ C15-PAL) Scale. Results: Patients frequently applied to the emergency department for pain (31.7%), dyspnea (16.2%), and nausea- vomiting (15.8%). In general, consultation was requested from 88.7% of the patients, and the most frequently consulted clinics were 49.8% internal medicine, 25.1% anaesthesia, 6.5% surgery and 6% chest diseases. The patients' emergency service visits resulted in 38.4% clinical admission, 32.1% discharge, 23.3% intensive care unit and 6.3% exitus. 67.2% of the patients had a PPS score of 70 or less. The patients' follow-up time in the emergency department was also determined to be a minimum of half an hour, a maximum of 5 hours, and an average of 1.9±1.2 hours. Conclusion: The study found that 93% of the patients did not receive palliative care support. Considering this basis, it can be recommended to provide the necessary guidance for cancer patients who apply to emergency departments to receive palliative care support and to structure this step within the health system. Such a structure may contribute to the diagnosis of patients who need palliative care support.

Anahtar Kelimeler

• Emergency deparment
• Oncological emergency
• Palliative care

Acil Servise Başvuran İleri Evre Kanser Hastalarının Palyatif Bakım Gereksinimlerinin Değerlendirilmesi

Öz

Amaç: Bu çalışmada acil servise başvuran ileri evre kanser hastalarının palyatif bakım gereksinimlerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Araştırma tanımlayıcı tipte olup İstanbul ilinde bulunan üç kamu hastanesinde 159 hasta ile gerçekleştirilmiştir. Çalışmada veriler Hasta Bilgilendirme Formu, Palyatif Performans Skalası ve Palyatif Bakım Alan Kanser Hastasının Yaşam Kalitesi (EORTC QLQ C15-PAL) skalası kullanılarak toplanmıştır. Bulgular: Hastaların acil servise en sık başvuru nedeni ağrı (%31,7), dispne (%16,2) ve bulantı kusmaydı (%15,8). Başvuruların %88,7'sinden konsültasyon istenmiş; %49,8 dahiliye, %25,1’i anestezi, %6,5 cerrahi ve %6 oranında göğüs hastalıklarına danışılmıştır. Hastaların %38,4’üne klinik yatış yapılmış, %32,1’i taburcu olurken, %23,3’üne yoğun bakım yatışı gerçekleştirilmiş ve %6,3’ü ise ölmüştür. Hastaların %67,2'sinin Palyatif Performans Skalası puanı 70 veya altındaydı. Hastaların acil servisteki izlemleri minimum yarım ya da bir saat, maksimum 5 saat, ortalama 1,9±1,2 saat sürmüştür. Sonuç: Araştırmada hastaların %93'ünün palyatif bakım bakım desteği almadığı saptanmıştır. Bu temelde ele alındığında acil servislere başvuran kanser hastalarının palyatif bakım desteği alması için gerekli yönlendirmelerin yapılması ve sağlık sistemi içine bu basamağın yapılandırılması önerilebilir. Böyle bir yapılanma palyatif bakım desteğine gereksinimi olan hastalarında tanılanmasına da katkıda bulunabilir.

Anahtar Kelimeler

• Acil servis
• onkolojik aciller
• palyatif bakım.

Kaynakça

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