- 作者：Karim S. El-Sahwi ; Jessica Illuzzi ; Joyce Varughese ; Nina Carusillo ; Elena S. Ratner ; Dan-Arin Silasi ; Masoud Azodi ; Peter E. Schwartz ; Thomas J. Rutherford ; Alessandro D. Santin<sup> ; sup><sup>alessandro.santin@yale.edusup>
- 关键词：End of Life ; Gynecologic cancer ; Gynecologic oncology ; Palliative care
- 刊名：Gynecologic Oncology
- 出版年：2012
- 出版时间：March 2012
- 年：2012
- 卷：124
- 期：3
- 页码：471-473
- 全文大小：127 K
ss=""h4"">Objectives.
To identify the practices and attitudes of gynecologic oncologists regarding the end-of-life discussion.ss=""h4"">Methods.
A pilot survey was sent to 1105 members of the Society of Gynecologic Oncologists (SGO). The survey consisted of 20 questions and was sent via the website Survey Monkey.
ss=""h4"">Results.
Response rate was 12.8 % . Sixty percent of respondents were male, most ranged between 30 and 60 years of age and more than half performed 5-10 major surgeries per week. More than half of respondents (53.9 % ) deferred the End of Life discussion until the patient had sustained a major change in functional and/or medical status. Thirty percent initiated it at the first recurrence or progression of disease. Forty three percent of respondents characterized the discussion as an on-going process. Patients' age, social support, health insurance, and co-morbidities had no influence on the discussion, and neither did the tumor's site of origin or grade. More respondents initiated the discussion in advanced stage cancer (57 % ) and after salvage chemotherapy institution (54 % ). Forty four percent of respondents reported that ¡°understanding and acceptance?was the initial response by patient when counseled about withdrawal of care. This increased to 86 % when the issue was revisited. Confusion or reluctance to discuss the subject were initially reported to be 12 % and 19 % , respectively, but decreased to 2 % and 3 % , respectively, when withdrawal of care was subsequently addressed with the patient.
ss=""h4"">Conclusions.
This pilot survey sheds a light on attitudes and practices about the end-of-life discussion that deserve to be further studied.