通过 "弱势老人调查 "对 75 岁及以上肺癌和妇科癌症患者进行早期电话虚弱筛查。

IF 2.4 3区 医学 Q1 NURSING Cancer Nursing Pub Date : 2024-11-05 DOI:10.1097/NCC.0000000000001421
Sandra Cabrera-Jaime, Anais Hernández-Marfil, Jordi Adamuz-Tomas, Silvia Sánchez-Martín
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引用次数: 0

摘要

背景:国际老年肿瘤学会建议所有患有癌症的老年人在开始治疗前接受老年病学评估:目的:确定被诊断患有肺癌或妇科癌症的 75 岁及以上老年人的体弱患病率,并评估在实施基于电话的 "弱势老年人调查"(VES-13)体弱筛查后,根据体弱情况调整标准治疗策略的情况:干预措施/方法:我们对 362 名患者进行了回顾性观察研究,这些患者在首次肿瘤预约前接受了高级执业护士的筛查。我们从电子病历中收集了二手数据。主要变量包括虚弱程度(根据 VES-13 和老年综合评估)、癌症治疗类型(标准治疗和处方治疗)、治疗完成情况、社会人口学特征和合并症:VES-13检测出186人(51.4%)有健康恶化的风险,综合老年评估证实157人(43.4%)有一定程度的虚弱,κ系数为0.84。合并症较多、体弱程度较高、老年病综合征较多的患者更有可能需要重新调整治疗方案(P < .001):由高级执业护士通过电话进行虚弱筛查显示出很高的适用性,初次就诊前被归类为虚弱者的比例与随后的老年病评估结果非常吻合:实践启示:由高级执业护士通过电话筛查确定虚弱风险的方案可促进护理过程,并帮助临床医生根据每位患者及其家属的需求调整治疗决策。
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Early Telephone-Based Frailty Screening With the Vulnerable Elders Survey in Adults Aged 75 Years and Older With Lung and Gynecological Cancer.

Background: The International Society of Geriatric Oncology recommends that all older people with cancer have a geriatric evaluation before beginning treatment.

Objective: To determine the prevalence of frailty in people 75 years and older diagnosed with lung or gynecological cancer and evaluate the adaptation of standard therapeutic strategies based on frailty, following the implementation of telephone-based frailty screening with the Vulnerable Elders Survey (VES-13).

Interventions/methods: We performed a retrospective observational study in 362 people screened by an advanced practice nurse before their first oncology appointment. We collected secondary data from electronic medical records. The main variables were degree of frailty (according to VES-13 and comprehensive geriatric assessment), type of cancer treatment (standard and prescribed), treatment completion, sociodemographic characteristics, and comorbidities.

Results: The VES-13 detected 186 people (51.4%) at risk of health deterioration, and the comprehensive geriatric assessment confirmed some degree of frailty in 157 people (43.4%), with a κ coefficient of 0.84. People with more comorbidities, greater frailty, and more geriatric syndromes were more likely to need treatment readjustment ( P < .001).

Conclusions: Telephone-based frailty screening by an advanced practice nurse showed high applicability, with very good agreement between the proportion of people classified as frail before the initial visit and in the subsequent geriatric assessment.

Implications for practice: A protocol for establishing frailty risk through telephone screening by an advanced practice nurse facilitates the care process and helps clinicians adapt therapeutic decision-making to the needs of each patient and their family.

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来源期刊
Cancer Nursing
Cancer Nursing 医学-护理
CiteScore
4.80
自引率
3.80%
发文量
244
审稿时长
6-12 weeks
期刊介绍: Each bimonthly issue of Cancer Nursing™ addresses the whole spectrum of problems arising in the care and support of cancer patients--prevention and early detection, geriatric and pediatric cancer nursing, medical and surgical oncology, ambulatory care, nutritional support, psychosocial aspects of cancer, patient responses to all treatment modalities, and specific nursing interventions. The journal offers unparalleled coverage of cancer care delivery practices worldwide, as well as groundbreaking research findings and their practical applications.
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