Symptom burden and lived experiences of patients, caregivers and healthcare professionals on the management of malignant bowel obstruction: A qualitative systematic review

Palliative Medicine - Tập 36 Số 6 - Trang 895-911 - 2022
Elin Baddeley1, Mala Mann1,2, Alison Bravington3, Miriam J. Johnson3, David C. Currow4, Fliss EM Murtagh3, Elaine Boland5, George Obita6, Alfred Oliver7,8, Kathy Seddon1, Annmarie Nelson1, Jason W Boland3, Simon Noble1
1Marie Curie Palliative Care Research Centre, Cardiff University, Cardiff, UK
2Specialist Unit for Review Evidence, Cardiff University, Cardiff, UK
3Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
4University of Technology Sydney, Sydney, NSW, Australia
5Queens Centre for Oncology and Haematology, Cottingham, Hull, UK
6Dove House Hospice, Hull, England, UK
7National Cancer Research Institute, Consumer Liaison Group
8National Cancer Research Institute, Consumer Liaison Group; Trans-Humber Consumer Research Panel, London, UK

Tóm tắt

Background: Malignant bowel obstruction occurs in up to 50% of people with advanced ovarian and 15% of people with gastrointestinal cancers. Evaluation and comparison of interventions to manage symptoms are hampered by inconsistent evaluations of efficacy and lack of agreed core outcomes. The patient perspective is rarely incorporated. Aim: To synthesise the qualitative data regarding patient, caregiver and healthcare professionals’ views and experience of malignant bowel obstruction to inform the development of a core outcome set for the evaluation of malignant bowel obstruction. Design: A qualitative systematic review was conducted, with narrative synthesis. The review protocol was registered prospectively ( https://www.crd.york.ac.uk/prospero , CRD42020176393). Data sources: MEDLINE, EMBASE, CINAHL, PsycINFO and Scopus databases were searched for studies published between 2010 and 2021. Reference lists were screened for further relevant publications, and citation tracking was performed. Results: Nine papers were included, reporting on seven studies which described the views and experiences of malignant bowel obstruction through the perspectives of 75 patients, 13 caregivers and 62 healthcare professionals. Themes across the papers included symptom burden, diverse experiences of interventions, impact on patient quality of life, implications and trajectory of malignant bowel obstruction, mixed experience of communication and the importance of realistic goals of care. Conclusion: Some of the most devastating sequelae of malignant bowel obstruction, such as pain and psychological distress, are not included routinely in its clinical or research evaluation. These data will contribute to a wider body of work to ensure the patient and caregiver perspective is recognised in the development of a core outcome set.

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Palliative Medicine

Tập 36 Số 6

895-911

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