Background and Objective The development of modern palliative care in China began in the 1980s and is currently in an accelerating phase.However,inconsistencies in terminology and concepts have hindered policy-making,...Background and Objective The development of modern palliative care in China began in the 1980s and is currently in an accelerating phase.However,inconsistencies in terminology and concepts have hindered policy-making,clinical practice,and academic research.The Terminology of Clinical Medicine(2023 edition)has determined huan-he-yi-liao(缓和医疗)and an-ning-liao-hu(安宁疗护)as the formal terms of"palliative care"and"hospice care",respectively.To align with these terms,this study aims to establish expert consensus definitions tailored to the Chinese context.Methods We systematically retrieved and collected domestic and international literature and policy documents related to the definition of palliative care,then deconstructed and analyzed the relevant conceptual elements of these definitions.Core expert panel built the initial recommended definition upon the conceptual elements and consensus definition of palliative care by the International Association for Hospice and Palliative Care(IAHPC)through two rounds of online discussions.After nomination and selection,61 professionals in the field of palliative care in China were invited to participate in the consensus expert group.Two rounds of Delphi consultation were conducted among the consensus experts,who were asked to score their agreement using Likert scale to the items in the initial recommended definition and the definition statements of palliative care and hospice care.Agreement rate of over 80%was considered as reaching consensus for each items.The core expert panel revised the items and the statements of recommended definitions based on the results from Delphi surveys.The final recommended definitions were formulated after feedback from patient and public involvement(PPI)group members.Results The response rates for the first and second round of Delphi surveys were 83.6%and 100.0%,respectively.The agreement rates of the items and statements of the recommended definitions exceeded 90%.Accordingly,the definitions based on Chinese expert consensus are recommended.Palliative care is an active holistic approach aimed at patients of all ages suffering from life-threatening illness and their families and caregivers.It seeks to improve their quality of life by preventing,assessing,and relieving physical,psychological,social,and spiritual suffering.Hospice care is an integral part of palliative care,focusing on holistic care for patients at the end of life and their families and caregivers.Its goal is to help patients to maintain dignity and achieve a good death by alleviating physical,psychological,social,and spiritual distress without intentionally hastening or postponing death,meanwhile improve the quality of life for families and caregivers.Conclusions This study has established the Chinese expert consensus definitions of palliative care and hospice care in China,as well as the relationship between the two.The definitions highlight the holistic nature of palliative care,providing a foundation for discipline development,clinical practice,and public communication.展开更多
Background and Objective Patients with glioma experience a high symptom burden and have diverse palliative care needs.However,the assessment scales used in palliative care remain non-standardized and highly heterogene...Background and Objective Patients with glioma experience a high symptom burden and have diverse palliative care needs.However,the assessment scales used in palliative care remain non-standardized and highly heterogeneous.To evaluate the application patterns of the current scales used in palliative care for glioma,we aim to identify gaps and assess the need for disease-specific scales in glioma palliative care.Methods We conducted a systematic search of five databases including PubMed,Web of Science,Medline,EMBASE,and CINAHL for quantitative studies that reported scale-based assessments in glioma palliative care.We extracted data on scale characteristics,domains,frequency,and psychometric properties.Quality assessments were performed using the Cochrane ROB 2.0 and ROBINS-I tools.Results Of the 3,405 records initially identified,72 studies were included.These studies contained 75 distinct scales that were used 193 times.Mood(21.7%),quality of life(24.4%),and supportive care needs(5.2%)assessments were the most frequently assessed items,exceeding half of all scale applications.Among the various assessment dimensions,the Distress Thermometer(DT)was the most frequently used tool for assessing mood,while the Short Form-36 Health Survey Questionnaire(SF-36)was the most frequently used tool for assessing quality of life.The Mini Mental Status Examination(MMSE)was the most common tool for cognitive assessment.Performance status(5.2%)and social support(6.8%)were underrepresented.Only three brain tumor-specific scales were identified.Caregiver-focused scales were limited and predominantly burden-oriented.Conclusions There are significant heterogeneity,domain imbalances,and validation gaps in the current use of assessment scales for patients with glioma receiving palliative care.The scale selected for use should be comprehensive and user-friendly.展开更多
Glioblastoma multiforme(GBM)is the most common malignant primary brain tumor with a poor prognosis and limited survival.Patients with GBM have a high demand for palliative care.In our present case,a 21-year-old female...Glioblastoma multiforme(GBM)is the most common malignant primary brain tumor with a poor prognosis and limited survival.Patients with GBM have a high demand for palliative care.In our present case,a 21-year-old female GBM patient received inpatient palliative care services including symptom management,mental and psychological support for the patient,psychosocial and clinical decision support for her family members,and pre-and post-death bereavement management for the family.Furthermore,we provided the family members with comprehensive psychological preparation for the patient's demise and assisted the patient's family throughout the mourning period.The aim of this study is to provide a reference and insights for the clinical implementation of palliative care for patients with malignant brain tumors.展开更多
Objective To testify the efficacy of ^18F-fluorodeoxyglucose （^18F-FDG） positron emission tomography （PET） in the diagnosis of cancer. Methods A total of 170 patients with diagnosed cancer or suspicious cancer wer...Objective To testify the efficacy of ^18F-fluorodeoxyglucose （^18F-FDG） positron emission tomography （PET） in the diagnosis of cancer. Methods A total of 170 patients with diagnosed cancer or suspicious cancer were enrolled in this study, and underwent ^18F-FDG PET. The standard uptake value （SUV） and diameter for each abnormal region in PET images were analyzed. All data were analyzed by SPSS 11.5. Results PET scan identified a primary cancer in 45.8% （11/24） patients. The sensitivity and specificity of PET scan in differentiating malignant lesions from benign ones were 78.8% （52/66） and 77.1% （27/35） respectively. Twenty-nine out of 68 （42.6%） lesions were detected earlier by PET than by computed tomography. The SHV of primary cancer was significantly higher than that of metastatic lymph nodes （5.84± 3.12 vs. 3.14± 2.24, P〈0.001）. And SLIV of primary lung cancer was also significantly higher than that of metastatic lung cancer （6.30±3.01 vs. 2.86±2.37, P〈0.01）.Conclusion ^18F-FDG PET plays a very important role in cancer diagnosis.展开更多
文摘Background and Objective The development of modern palliative care in China began in the 1980s and is currently in an accelerating phase.However,inconsistencies in terminology and concepts have hindered policy-making,clinical practice,and academic research.The Terminology of Clinical Medicine(2023 edition)has determined huan-he-yi-liao(缓和医疗)and an-ning-liao-hu(安宁疗护)as the formal terms of"palliative care"and"hospice care",respectively.To align with these terms,this study aims to establish expert consensus definitions tailored to the Chinese context.Methods We systematically retrieved and collected domestic and international literature and policy documents related to the definition of palliative care,then deconstructed and analyzed the relevant conceptual elements of these definitions.Core expert panel built the initial recommended definition upon the conceptual elements and consensus definition of palliative care by the International Association for Hospice and Palliative Care(IAHPC)through two rounds of online discussions.After nomination and selection,61 professionals in the field of palliative care in China were invited to participate in the consensus expert group.Two rounds of Delphi consultation were conducted among the consensus experts,who were asked to score their agreement using Likert scale to the items in the initial recommended definition and the definition statements of palliative care and hospice care.Agreement rate of over 80%was considered as reaching consensus for each items.The core expert panel revised the items and the statements of recommended definitions based on the results from Delphi surveys.The final recommended definitions were formulated after feedback from patient and public involvement(PPI)group members.Results The response rates for the first and second round of Delphi surveys were 83.6%and 100.0%,respectively.The agreement rates of the items and statements of the recommended definitions exceeded 90%.Accordingly,the definitions based on Chinese expert consensus are recommended.Palliative care is an active holistic approach aimed at patients of all ages suffering from life-threatening illness and their families and caregivers.It seeks to improve their quality of life by preventing,assessing,and relieving physical,psychological,social,and spiritual suffering.Hospice care is an integral part of palliative care,focusing on holistic care for patients at the end of life and their families and caregivers.Its goal is to help patients to maintain dignity and achieve a good death by alleviating physical,psychological,social,and spiritual distress without intentionally hastening or postponing death,meanwhile improve the quality of life for families and caregivers.Conclusions This study has established the Chinese expert consensus definitions of palliative care and hospice care in China,as well as the relationship between the two.The definitions highlight the holistic nature of palliative care,providing a foundation for discipline development,clinical practice,and public communication.
文摘Background and Objective Patients with glioma experience a high symptom burden and have diverse palliative care needs.However,the assessment scales used in palliative care remain non-standardized and highly heterogeneous.To evaluate the application patterns of the current scales used in palliative care for glioma,we aim to identify gaps and assess the need for disease-specific scales in glioma palliative care.Methods We conducted a systematic search of five databases including PubMed,Web of Science,Medline,EMBASE,and CINAHL for quantitative studies that reported scale-based assessments in glioma palliative care.We extracted data on scale characteristics,domains,frequency,and psychometric properties.Quality assessments were performed using the Cochrane ROB 2.0 and ROBINS-I tools.Results Of the 3,405 records initially identified,72 studies were included.These studies contained 75 distinct scales that were used 193 times.Mood(21.7%),quality of life(24.4%),and supportive care needs(5.2%)assessments were the most frequently assessed items,exceeding half of all scale applications.Among the various assessment dimensions,the Distress Thermometer(DT)was the most frequently used tool for assessing mood,while the Short Form-36 Health Survey Questionnaire(SF-36)was the most frequently used tool for assessing quality of life.The Mini Mental Status Examination(MMSE)was the most common tool for cognitive assessment.Performance status(5.2%)and social support(6.8%)were underrepresented.Only three brain tumor-specific scales were identified.Caregiver-focused scales were limited and predominantly burden-oriented.Conclusions There are significant heterogeneity,domain imbalances,and validation gaps in the current use of assessment scales for patients with glioma receiving palliative care.The scale selected for use should be comprehensive and user-friendly.
基金National High Level Hospital Clinical Research Funding(2022-PUMCH-B-113).
文摘Glioblastoma multiforme(GBM)is the most common malignant primary brain tumor with a poor prognosis and limited survival.Patients with GBM have a high demand for palliative care.In our present case,a 21-year-old female GBM patient received inpatient palliative care services including symptom management,mental and psychological support for the patient,psychosocial and clinical decision support for her family members,and pre-and post-death bereavement management for the family.Furthermore,we provided the family members with comprehensive psychological preparation for the patient's demise and assisted the patient's family throughout the mourning period.The aim of this study is to provide a reference and insights for the clinical implementation of palliative care for patients with malignant brain tumors.
文摘Objective To testify the efficacy of ^18F-fluorodeoxyglucose （^18F-FDG） positron emission tomography （PET） in the diagnosis of cancer. Methods A total of 170 patients with diagnosed cancer or suspicious cancer were enrolled in this study, and underwent ^18F-FDG PET. The standard uptake value （SUV） and diameter for each abnormal region in PET images were analyzed. All data were analyzed by SPSS 11.5. Results PET scan identified a primary cancer in 45.8% （11/24） patients. The sensitivity and specificity of PET scan in differentiating malignant lesions from benign ones were 78.8% （52/66） and 77.1% （27/35） respectively. Twenty-nine out of 68 （42.6%） lesions were detected earlier by PET than by computed tomography. The SHV of primary cancer was significantly higher than that of metastatic lymph nodes （5.84± 3.12 vs. 3.14± 2.24, P〈0.001）. And SLIV of primary lung cancer was also significantly higher than that of metastatic lung cancer （6.30±3.01 vs. 2.86±2.37, P〈0.01）.Conclusion ^18F-FDG PET plays a very important role in cancer diagnosis.
