晚期癌症患者预后沟通策略的证据总结

Summary of the evidence on strategies for prognostic communication in advanced cancer patients

目的评价并总结晚期癌症患者预后沟通策略的最佳证据,为临床实践提供参考。方法根据“6S”证据模型,检索晚期癌症患者预后沟通相关的所有证据,包括临床指南、临床决策、专家共识、系统评价。评价纳入文献的质量,进行证据的归纳与总结。结果共纳入7篇文献,其中1篇临床决策、2篇指南、4篇系统评价,汇总了沟通前评估、沟通前准备、沟通时技巧、促进希望的方式、提高沟通能力共5个方面19条证据。结论晚期癌症患者预后沟通策略最佳证据可为临床相关人员与晚期癌症患者进行良好的预后沟通提供参考。但在证据转化时需进行本土化决策,以提高晚期癌症患者生活质量。

Objective To evaluate and summarize the best evidence on how to communicate prognosis with advanced cancer patients,and to provide reference for clinical practice.Methods According to the 6S evidence pyramid model,clinical guideline,best practice statement,expert consensus statement and systematic review related to the communication of prognosis to advanced cancer patients were retrieved.Methodological quality of the literature was evaluated and evidence was summarized.Results One best practice statement,two guidelines,and four systematic reviews were included.Nineteen pieces of evidence were summarized and categorized into five aspects:assessment before communication,preparation before communication,communication skills,ways to promote hope,and improving communication ability.Conclusion The best evidence of strategies for prognostic communication in advanced cancer patients can provide reference for clinical personnel,but local adjustment should be made before clinical practice to improve quality of life of patients.