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Tidig integrering av palliativ vård för patienter med hematologisk cancer: en litteraturöversikt
Sophiahemmet University.
Sophiahemmet University.
2024 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesisAlternative title
Early integration of palliative care in patients with hematologic cancer : a literature review (English)
Abstract [sv]

Bakgrund: Trots att stora framsteg har gjorts senaste åren kring behandling av hematologiska cancersjukdomar, avlider fortfarande en stor del av patienterna till följd av sjukdomen eller komplikationer relaterade till sjukdom och behandling. Patienter med hematologisk cancer tillbringar ofta långa perioder på sjukhus på grund av långtgående behov av intravenöst antibiotika, transfusioner och cytostatikabehandlingar. De erbjuds inte palliativ vård i samma utsträckning som patienter med solida tumörsjukdomar, detta trots att de visar sig ha liknande symtombörda som patienter med andra cancerformer. Flera studier har publicerats senaste åren som visar att tidig integrering av palliativ vård vid solida tumörsjukdomar förbättrar fysisk och psykisk hälsa, minskar symtombörda och medför positiva effekter på övergripande livskvalitet. Effekt av tidig integrering av palliativ vård vid hematologisk cancer anses därför angeläget att undersöka.

Syfte: Att undersöka hur tidig integrering av palliativ vård för patienter med hematologisk cancer påverkar patientens livskvalitet.

Metod: Litteraturöversikt med induktiv ansats har genomförts med litteratursökningar i databaserna CINAHL, Pubmed och PsycINFO. Totalt fjorton kvantitativa artiklar om tidig palliativ vård vid hematologisk cancer analyserades med begreppet personcentrerad vård som teoretiskt ramverk.

Resultat: Flera aspekter av livskvalitet förbättrades vid tidig integrerad palliativ vård vid hematologisk cancer. Smärta och psykiska symtom minskade, patientdelaktighet ökade genom fler genomförda samtal och information om sjukdom och prognos. Färre dödsfall på intensivvårdsavdelning sågs och färre aggressiva behandlingar i livets slutskede. Genom specifika skattningsinstrument för hälsorelaterad eller sjukdomsspecifik livskvalitet påvisades lägre minskning av livskvalitet under sjukdomsförloppet jämfört med enbart sedvanlig vård.

Slutsats: Palliativ vård tillsammans med sedvanligt hematologisk vård är till gagn för patienter med hematologisk cancer och kan implementeras tidigt i sjukdomsförloppet för att främja livskvaliteten. Fler randomiserade kontrollerade kliniska studier behövs för att kunna fortsätta utveckla en palliativ vård som kan tillgodose de specifika behov en patient med hematologisk cancer kan ha.

Abstract [en]

Background: Although great progress has been made in recent years in the treatment of hematological cancers, a large proportion of patients still die as a result of the disease, or complications related to disease and treatment. Patients with hematological cancer often spend long periods of time in hospital due to far-reaching needs for intravenous antibiotics, transfusions, and chemotherapy treatments. They are not offered palliative care to the same extent as patients with solid tumor diseases, despite the fact that they are found to have a similar symptom burden as patients with other cancers. Several studies have been published in recent years showing that early integration of palliative care in solid tumor diseases improves physical and mental health, reduces symptom burden, and has positive effects on overall quality of life. The effect of early integration of palliative care in hematological cancer is therefore considered important to investigate.

Aim: The aim of this review was to explore how early integrated palliative care for patients with hematologic cancer affects the patients’ quality of life.

Method: A literature review with an inductive approach has been conducted with literature searches in the databases CINAHL, Pubmed and PsycINFO. A total of fourteen quantitative studies on early palliative care in hematological cancer were analyzed using the concept of person-centered care as a theoretical framework.

Results: Several aspects of quality of life were improved in early integrated palliative care in hematological cancer. Pain and psychological symptoms decreased, patient participation increased through more completed conversations and information about illness and prognosis. There were fewer deaths in intensive care units and fewer aggressive treatments at the end of life. Through specific assessment instruments for health-related or disease-specific quality of life, lower reductions in quality of life during the course of the disease were demonstrated compared to usual care alone.

Conclusion: Palliative care together with usual hematological care is beneficial for patients with hematological cancer and can be implemented early in the course of the disease to promote quality of life. More randomized controlled clinical trials are needed to continue to develop palliative care that can meet the specific needs of a patient with hematological cancer.

Place, publisher, year, edition, pages
2024. , p. 33
Keywords [en]
Quality of life, Palliative care, Hematology, Early integration
Keywords [sv]
Livskvalitet, Palliativ vård, Hematologi, Tidig integrering
National Category
Nursing
Identifiers
URN: urn:nbn:se:shh:diva-5266OAI: oai:DiVA.org:shh-5266DiVA, id: diva2:1852746
Educational program
Specialistsjuksköterskeprogram inriktning palliativ vård, (Samordnat av Marie Cederschiöld högskola och Sophiahemmet högskola)
Uppsok
Medicine
Supervisors
Examiners
Available from: 2024-04-19 Created: 2024-04-19 Last updated: 2024-04-19Bibliographically approved

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