Impact Of Early Initiation Of Palliative Care On The Quality Of Life Of Patients With Malignant Tumor

Objective: In the treatment of patients with advanced malignant tumors,palliative care affects the body feeling and quality of life of patients through its unique mechanism.This study through a prospectie,randomized controlled trials,explore the early start of palliative treatment of malignant tumor patients life quality,pain,depression,anxiety,psychological condition the influence of the quartet,and explore the palliative therapy for Chinese patients with malignant tumor,and to explore the early start of palliative treatment for the patient surial.Methods:1.A total of 128 newly treated patients with malignant tumor who were admitted to the Department of Oncology of the Fourth Hospital of Hebei Medical University from January 2014 to January 2015 were included.A total of 128 patients who met the inclusion criteria and did not meet the exclusion criteria were randomly divided into the control group(64 patients)and the experimental group(64 patients)according to 1:1 randomization.2.According to the EORTC QLQ-C30 scale,psychological pain thermometer,SDS self-rating depression scale,SAS self-rating anxiety scale,the quality of life,mental state and mental state of patients before and after palliative care were evaluated.In addition to receiving routine chemotherapy and routine nursing,intervention measures were immediately initiated in the experimental group after randomized grouping,such as timely guidance and help to patients and their families by telephone,We Chat,and conversation,etc.,while the control group only received routine chemotherapy and routine nursing.After 12 weeks,the scale evaluation was performed again to compare the scale scores of the two groups of patients before and after treatment,so as to evaluate the influence and effect of palliative care on patients with advanced tumor.3.Patients were followed up by telephone contact to record survival status,with a follow-up deadline of February 1,2021.Total survival was defined as the time from the first treatment received after enrollment to the date of death or the end of follow-up.4.Statistical analysis software SPSS 25.0 was used to complete data statistics and analysis.Classification is conducted according to data types.If it is measurement data,K-S normal analysis is used to analyze whether it conforms to normal distribution;if it conforms to normal distribution,t test is used;otherwise,rank sum test is used.If it was enumeration data,it was further divided into rank disordered enumeration data and rank enumeration data.The former used χ2 test,the latter used rank sum test,and the paired t test was used for intra-group comparison.Overall survival(OS)was calculated on a monthly basis and univariate analysis was performed using Kaplan-Meier model.The test level α=0.05.Results:1.Influence of palliative care on patients’ quality of lifeA total of 128 patients were enrolled in this study,of which 8(2 in the experimental group and 6 in the control group)withdrew from the study due to disease changes,refusal of further treatment or hospital transfer,etc.In fact,a total of 120 patients participated in the study,including 62 in the experimental group and 58 in the control group.There was no statistical significance between the two groups in gender,age,marital status,educational level,per capita monthly income,reimbursement methods,cancer types and tumor stages.There was no statistical difference in the QLQ-C30 scale scores between the two groups at the time of enrollment.After palliative care,the QLQ-C30 scale scores in the experimental group were lower than those in the treatment control group(t=2.015,P=0.046).2.The influence of palliative care on patients’ psychological painThere was no statistical difference in psychological pain scores between the two groups before palliative treatment,and after palliative treatment,there was still no statistical difference in psychological pain scores between the two groups.However,the median degree of psychological pain in the two groups was lower than before,and the psychological pain scores before and after intervention in the experimental group were statistically significant(Z=-2.006,P=0.045).3.Influence of palliative care on depression and anxiety of patientsBefore palliative treatment,there was no statistical difference in SDS depression rating scale and SAS anxiety rating scale between the two groups.After palliative treatment,the scores of SAS anxiety rating scale were statistically significant(Z=-2.010,P=0.044).There was no statistically significant difference in the SDS depression scale,but the number of people without depression or mild depression decreased after treatment.4.Effect of palliative care on patient survivalSurvival follow-up was conducted for 120 patients participating in the study,of whom 13(7 in the experimental group and 6 in the control group)had family members who were unable to obtain a definitive survival period because they could not be contacted and did not cooperate with the follow-up.After testing and analysis: there was no statistically significant difference in the effect of palliative care on survival(P=0.190).Conclusions:1.Our study suggests that palliative care can improve the quality of life of patients with malignancy,in line with previous studies.2.Standardized treatment combined with palliative care can improve the psychological pain of patients,so as to reduce the pain of patients.3.Palliative care can improve the mental state of depression and anxiety of patients with advanced malignant tumor,so as to better help the emotional excretion and establish a good physical and mental health.4.Early initiation of palliative care did not extend patient survival.