Factors Influencing the Quality of Life (QOL) of Advanced Cancer Patients in Home-based Palliative Care (HBPC): A Systematic Review.

Q2 Medicine Asian Pacific Journal of Cancer Prevention Pub Date : 2024-11-01 DOI:10.31557/APJCP.2024.25.11.3789

Ajay Kumar Kondeti, Kesava Ramgopal Adavikolanu, Soorej Balan Kaliyath, Yamini Marimuthu, Haveela Mary Nannepaga, Gopi Krishna Shyam, Shoban Babu Varthya

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Abstract

Context: Despite the widespread recognition of the need for new palliative care models to better serve advanced cancer patients at the end of life, little importance is given to assessing the effectiveness of homecare models.

Objective: This systematic review aims to summarize factors influencing the quality of life (QOL) of advanced cancer patients in home-based palliative care (HBPC) being adopted worldwide.

Methods: Following the PRISMA guidelines, electronic databases such as MEDLINE, Cochrane, EMBASE, and Scopus databases from 2000 to February 2024 were systematically searched using predetermined search terms of "quality of life", "home-based palliative care" as well as "advanced cancer". Studies with less than ten subjects, scoping reviews, conference abstracts, and that adopted poorly validated QOL questionnaires were excluded.

Results: Twenty-two (22) studies from both developed and developing countries were included in the narrative synthesis. 45.4% were cross-sectional, 27.2% were prospective cohort studies, 13.6% were retrospective cohort studies, and 18.1% were RCTs or quasi-experimental studies. Around 33 QOL factors were studied with 16 different types of QOL instruments. Advanced cancer patients who practiced spirituality, female gender, were married, had satisfaction with care, and preferred home as a place of death showed higher QOL scores. Older patients, aware of cancer diagnosis, poor performance status, high pain score, symptom distress, and psychological distress were associated with a poor QOL.

Conclusion: Various factors affect QOL among cancer patients in HBPC. Hence it shows the importance of interventions to improve QOL and their rigorous implementation. With the widespread adoption of multi-disciplinary home care palliative programs, palliative care services to advanced cancer patients can be delivered readily which may be cost-effective.

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影响晚期癌症患者居家姑息治疗（HBPC）生活质量的因素：一项系统综述

背景：尽管人们普遍认识到需要新的姑息治疗模式来更好地为晚期癌症患者提供临终服务，但很少有人重视评估家庭护理模式的有效性。目的：本系统综述旨在总结影响世界范围内晚期癌症患者居家姑息治疗（HBPC）生活质量（QOL）的因素。方法：按照PRISMA指南，系统检索2000年至2024年2月的MEDLINE、Cochrane、EMBASE和Scopus等电子数据库，使用预先确定的“生活质量”、“居家姑息治疗”和“晚期癌症”等检索词。少于10个主题的研究、范围综述、会议摘要以及采用验证不佳的生活质量问卷的研究被排除在外。结果：来自发达国家和发展中国家的22项研究被纳入叙事综合。45.4%为横断面研究，27.2%为前瞻性队列研究，13.6%为回顾性队列研究，18.1%为随机对照试验或准实验研究。采用16种不同类型的生活质量仪器对33个生活质量因素进行了研究。修道、女性、已婚、对照护满意、选择家作为死亡地点的晚期癌症患者的生活质量得分较高。年龄较大、意识到癌症诊断、表现状态差、疼痛评分高、症状困扰、心理困扰与较差的生活质量相关。结论：影响HBPC患者生活质量的因素多种多样。因此，这表明干预措施对改善生活质量及其严格实施的重要性。随着多学科家庭姑息治疗方案的广泛采用，晚期癌症患者的姑息治疗服务可以随时提供，并且可能具有成本效益。

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来源期刊

Asian Pacific Journal of Cancer Prevention 医学-肿瘤学

CiteScore

2.80

自引率

0.00%

发文量

779

审稿时长

3 months

期刊介绍： Cancer is a very complex disease. While many aspects of carcinoge-nesis and oncogenesis are known, cancer control and prevention at the community level is however still in its infancy. Much more work needs to be done and many more steps need to be taken before effective strategies are developed. The multidisciplinary approaches and efforts to understand and control cancer in an effective and efficient manner, require highly trained scientists in all branches of the cancer sciences, from cellular and molecular aspects to patient care and palliation. The Asia Pacific Organization for Cancer Prevention (APOCP) and its official publication, the Asia Pacific Journal of Cancer Prevention (APJCP), have served the community of cancer scientists very well and intends to continue to serve in this capacity to the best of its abilities. One of the objectives of the APOCP is to provide all relevant and current scientific information on the whole spectrum of cancer sciences. They aim to do this by providing a forum for communication and propagation of original and innovative research findings that have relevance to understanding the etiology, progression, treatment, and survival of patients, through their journal. The APJCP with its distinguished, diverse, and Asia-wide team of editors, reviewers, and readers, ensure the highest standards of research communication within the cancer sciences community across Asia as well as globally. The APJCP publishes original research results under the following categories: -Epidemiology, detection and screening. -Cellular research and bio-markers. -Identification of bio-targets and agents with novel mechanisms of action. -Optimal clinical use of existing anti-cancer agents, including combination therapies. -Radiation and surgery. -Palliative care. -Patient adherence, quality of life, satisfaction. -Health economic evaluations.