緩和ケアと医学

抽象的な

Risk and Uncertainty in Anesthesia

Cathy L Campbell and Lisa C Campbell

Introduction: Men with long term advanced cancer of the prostate can be considered transitional cancer survivors because many have complex physical, emotional, and psychosocial needs that extend beyond the active treatment period. Methods: Health care providers completed a survey identifying the needs most common to men with advancedprostate cancer. Descriptive statistics were used to describe the sample and analyze the survey data, including means for continuous variables and frequencies for categorical variables. Qualitative content analysis was used to analyze the cancer-related topics suggested by the respondents that were not included in the questionnaire. Results: Thirty providers completed the survey. Mean age of respondent was 46.8 years. The majority of participants reported that their race was White, indicated that they were physicians, and reported that they practiced in outpatient or ambulatory care settings. The respondent’s mean years in the current clinical role, current clinical setting and experience with people with advanced cancer was 17.8 years, 11.0, and 17.3, respectively. The needs identified by the respondents as important (listed from highest to lowest frequency) were help with decisions (92%), help with hands-on care (88%), and referral to community resources (88%), financial assistance (85%), help with anxiety or depression (85%), help with grieving (77%), and help with an advanced directive (73%). The needs that least likely to be addressed by the health care providers in their clinical settings were financial assistance (95%), spiritual care (84%), and help with grieving (58%). Discussion: While community-based physician practices are able to address the direct physical needs, they may have limited ability to provide emotional, spiritual or financial support that are needed by families. Given the large and growing number of long-term survivors, the time has come to develop comprehensive plans of care that integrate palliative care principles throughout all phases of the cancer journey.