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Myélome multiple et approche palliative des soins : étude théorique ancrée dans la pratique
Abstract
Objectif : Le myélome multiple est un cancer hématologique incurable. Pour alléger la souffrance, il est possible d’employer une approche palliative en conjonction avec un traitement curatif, mais cette approche est sous-utilisée chez les patients en hémato-oncologie. L’objectif de la présente étude est d’examiner l’expérience des personnes atteintes d’un myélome multiple qui reçoivent un traitement palliatif dans le cadre de leurs soins, et de comprendre comment ils perçoivent cette approche.
Méthodologie : La présente étude suit le modèle de la théorie ancrée de Strauss. En tout, 10 personnes atteintes de myélome multiple y ont participé entre octobre 2021 et mai 2022.
Résultats : Les chercheuses ont créé un modèle théorique illustrant le processus de l’expérience du myélome multiple. Les données ont permis d’extrapoler 7 catégories, ainsi qu’une catégorie centrale, c’est-à-dire « le fait d’exister dans l’espace liminal entre la vie avec le myélome multiple et la mort à cause de la maladie ». Selon les résultats, le recours à l’approche palliative manquait de constance.
Conclusion : Le modèle conçu à partir des données recueillies auprès des participants rend compte de l’expérience du myélome multiple et de l’utilité de l’approche palliative.
Mots-clés : myélome multiple, approche palliative des soins, théorie ancrée
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Alberta Health Services. (2015). Clinical practice guideline: Multiple myeloma. https://www.albertahealthservices.ca/assets/info/hp/cancer/if-hp-cancer-guide-lyhe003-multi-myeloma.pdf
Alberta Health Services. (2018). Serious illness care program. https://www.albertahealthservices.ca/assets/info/acp/if-acp-qi-sicg-clinician-reference-guide.pdf
Alberta Health Services. (2021). Integrating an early palliative approach into advanced cancer care. https://www.albertahealthservices.ca/assets/info/hp/cancer/if-hp-cancer-guide-supp023-early-palliative-care-advanced-cancer.pdf
Beddard-Huber, E., Strachan, P., Brown, S., Kennedy, V., Marles, M. M., Park, S., & Roberts, D. (2021). Supporting interprofessional engagement in serious illness conversations: An adapted resource. Journal of Hospice and Palliative Nursing, 23(1), 38–45.
Bernacki, R. E., & Block, S. D. (2014). Communication about serious illness care goals. Journal of the American Medical Association, 174(12), 1994–2003. https://doi.org/10.1001/jamainternmed.2014.5271
Canadian Hospice Palliative Care Association. (2012). The way forward. The palliative approach: Improving care for Canadians with life-limiting illness. http://www.hpcintegration.ca/media/23816/TWF-palliative-approach-report-English-final.pdf
Corbin, J., & Strauss, A. (1990). Basics of qualitative research: Grounded theory procedures and techniques. SAGE Publications.
Corbin, J., & Strauss, A. (2008). Basics of qualitative research (3rd ed.). SAGE Publications.
Corbin, J., & Strauss, A. (2015). Basics of qualitative research: Techniques and procedures for developing grounded theory (4th ed.). SAGE Publications.
Cuffe, C. H., Quirke, M. B., & McCabe, C. (2020). Patients’ experiences of living with multiple myeloma. British Journal of Nursing, 29(2), 103–110. https://doi.org/10.12968/bjon.2020.29.2.103
Dalal, S., Palla, S., Hui, D., Nguyen, L., Chacko, R., Li, Z., Fadul, N., Scott, C., Thornton, V., Coldman, B., Amin, Y., & Bruera, E. (2011). Association between a name change from palliative to supportive care and the timing of patient referrals at a comprehensive cancer center. The Oncologist, 16(1), 105–111. https://doi.org/10.1634/theoncologist.2010-0161
De Wet, R., Lane, H., Tandon, A., Augustson, B., & Joske, D. (2019). ‘It is a journey of discovery’: Living with myeloma. Supportive Care in Cancer, 27(7), 2435–2442. https://doi.org/10.1007/s00520-018-4502-9
El-Jawahri, A., LeBlanc, T., Vandusen, H., Traeger, L., Greer, J. A., Pirl, W. F., Jackson, V. A., Telles, J., Rhodes, A., Spitzer, T. R., McAfee, S., Chen, Y.-B. A., Lee, S. S., & Temel, J. S. (2016). Effect of inpatient palliative care on quality of life 2 weeks after hematopoietic stem cell transplantation. Journal of the American Medical Association, 316(20), 2094–2103. https://doi.org/10.1001/jama.2016.16786
El-Jawahri, A., Nelson, A. M., Gray, T. F., Lee, S. J., & LeBlanc, T. W. (2020). Palliative and end-of-life care for patients with hematologic malignancies. Journal of Clinical Oncology, 38(9), 944–953. https://doi.org/https://dx.doi.org/10.1200/JCO.18.02386
Fishman, J. M., Greenberg, P., Bagga, M. B., Casarett, D., & Propert, K. (2018). Increasing information dissemination in cancer communication: Effects of using “palliative,” “supportive,” or “hospice” care terminology. Journal of Palliative Medicine, 21(6), 820–824. https://doi.org/10.1089/jpm.2017.0650
Fliedner, M. C., Zambrano, S. C., & Eychmueller, S. (2021). Public perception of palliative care: A survey of the general population. Palliative Care and Social Practice, 15, 1–11. https://doi.org/10.1177/26323524211017546
Gärtner, J., Daun, M., Wolf, J., Von Bergwelt-Baildon, M., & Hallek, M. (2019). Early palliative care: Pro, but please be precise! Oncology Research and Treatment, 42(1-2), 11–18. https://doi.org/10.1159/000496184
Hao, Y., Zhan, L., Huang, M., Cui, X., Zhou, Y., & Xu, E. (2021). Nurses’ knowledge and attitudes towards palliative care and death: A learning intervention. Bio Med Central Palliative Care, 20(1). https://doi.org/10.1186/s12904-021-00738-x
Health Canada. (2018). Framework on palliative care in Canada. https://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/palliative-care/framework-palliative-care-canada.html
Hjelmfors, L., Van Der Wal, M. H. L., Friedrichsen, M. J., Mårtensson, J., Strömberg, A., & Jaarsma, T. (2015). Patient-nurse communication about prognosis and end-of-life care. Journal of Palliative Medicine, 18(10), 865–871. https://doi.org/10.1089/jpm.2015.0037
Howell, D. A., Shellens, R., Roman, E., Garry, A. C., Patmore, R., & Howard, M. R. (2011). Haematological malignancy: Are patients appropriately referred for specialist palliative and hospice care? A systematic review and meta-analysis of published data. Palliative Medicine, 25(6), 630–641. https://doi.org/10.1177/0269216310391692
Hui, D., Bansal, S., Park, M., Reddy, A., Cortes, J., Fossella, F., & Bruera, E. (2015). Differences in attitudes and beliefs toward end-of-life care between hematologic and solid tumor oncology specialists. Annals of Oncology, 26(7), 1440–1446. https://doi.org/10.1093/annonc/mdv028
Hui, D., Kim, S.-H., Kwon, J. H., Tanco, K. C., Zhang, T., Kang, J. H., Rhondali, W., Chisholm, G., & Bruera, E. (2012). Access to palliative care among patients treated at a comprehensive cancer center. The Oncologist, 17(12), 1574–1580. https://dx.doi.org/10.1634/theoncologist.2012-0192
Kanapuru, B., Fernandes, L. L., Fashoyin-Aje, L. A., Baines, A. C., Bhatnagar, V., Ershler, R., Gwise, T., Kluetz, P., Pazdur, R., Pulte, E., Shen, Y. L., & Gormley, N. (2022). Analysis of racial and ethnic disparities in multiple myeloma US FDA drug approval trials. Blood Advances, 6(6), 1684–1691. https://doi.org/10.1182/bloodadvances.2021005482
Karlsson, M., Friberg, F., Wallengren, C., & Öhlén, J. (2014). Meanings of existential uncertainty and certainty for people diagnosed with cancer and receiving palliative treatment: A life-world phenomenological study. Bio Med Central Palliative Care, 13(28), 1–9. https://doi.org/10.1186/1472-684x-13-28
Kelly, M., & Dowling, M. (2011). Patients’ lived experience of myeloma. Nursing Standard, 25(28), 38–44. https://doi.org/10.7748/ns2011.03.25.28.38.c8397
Kiely, F., Cran, A., Finnerty, D., & O’Brien, T. (2017). Self-reported quality of life and symptom burden in ambulatory patients with multiple myeloma on disease-modifying treatment. American Journal of Hospice and Palliative Medicine, 34(7), 671–676. https://doi.org/10.1177/1049909116646337
Li, X., Liu, J., Chen, M., Gu, J., Huang, B., Zheng, D., & Li, J. (2020). Health-related quality of life of patients with multiple myeloma: A real-world study in China. Cancer Medicine, 9(21), 7896–7913. https://doi.org/10.1002/cam4.3391
Mols, F., Oerlemans, S., Vos, A. H., Koster, A., Verelst, S., Sonneveld, P., & Poll-Franse, L. V. (2012). Health-related quality of life and disease-specific complaints among multiple myeloma patients up to 10 yr after diagnosis: Results from a population-based study using the PROFILES registry. European Journal of Haematology, 89(4), 311–319. https://doi.org/10.1111/j.1600-0609.2012.01831.x
Monterosso, L., Taylor, K., Platt, V., Lobb, E., Musiello, T., Bulsara, C., Stratton, K., Joske, D., & Krishnasamy, M. (2018). Living with multiple myeloma. Journal of Patient Experience, 5(1), 6–15. https://doi.org/10.1177/2374373517715011
Murray, S. A., Kendall, M., Mitchell, G., Moine, S., Amblàs-Novellas, J., & Boyd, K. (2017). Palliative care from diagnosis to death. British Medical Journal, 356(878), 1–8. https://doi.org/10.1136/bmj.j878
Myeloma Canada. (2017). Multiple myeloma patient handbook. https://myelomacanada.ca/pixms/uploads/serve/ckeditor/myeloma_canada_patient_handbook_10_2017-2.pdf
Nipp, R. D., El-Jawahri, A., Fishbein, J. N., Gallagher, E. R., Stagl, J. M., Park, E. R., Jackson, V. A., Pirl, W. F., Greer, J. A., & Temel, J. S. (2016). Factors associated with depression and anxiety symptoms in family caregivers of patients with incurable cancer. Annals of Oncology, 27(8), 1607–1612. https://doi.org/10.1093/annonc/mdw205
O’Brien, S. (2011). Advances in LLM. Current developments in the management of leukemia, lymphoma, and myeloma. Clinical Advances in Hematology & Oncology, 9(9), 684–686. https://www.hematologyandoncology.net/files/2013/09/ho0911_llm1.pdf
Swami, M., & Case, A. (2018). Effective palliative care: What is involved? Oncology, 32(4), 180–184. https://www.cancernetwork.com/view/effective-palliative-care-what-involved
Tay, J., Compton, S., Phua, G., Zhuang, Q., Neo, S., Lee, G., Wijaya, L., Chiam, M., Woong, N., & Krishna, L. (2021). Perceptions of healthcare professionals towards palliative care in internal medicine wards: A cross-sectional survey. Bio Med Central Palliative Care, 20(101), 1–8. https://doi.org/10.1186/s12904-021-00787-2
Temel, J. S., Greer, J. A., Muzikansky, A., Gallagher, E. R., Admane, S., Jackson, V. A., Dahlin, C. M., Blinderman, C. D., Jacobsen, J., Pirl, W. F., Billings, J. A., & Lynch, T. J. (2010). Early palliative care for patients with metastatic non-small-cell lung cancer. New England Journal of Medicine, 363(8), 733–742. https://doi.org/10.1056/nejmoa1000678
Tsatsou, I., Konstantinidis, T., Kalemikerakis, I., Adamakidou, T., Vlachou, E., & Govina, O. (2021). Unmet supportive care needs of patients with hematological malignancies: A systematic review. Asia-Pacific Journal of Oncology Nursing, 8(1), 5–17. https://doi.org/10.4103/apjon.apjon_41_20
Vlossak, D., & Fitch, M. I. (2008). Multiple myeloma: The patient’s perspective. Canadian Oncology Nursing Journal, 18(3), 141–146. https://doi.org/10.5737/1181912x183141145
World Health Organization. (2020). Palliative care. https://www.who.int/news-room/fact-sheets/detail/palliative-care
Zimmermann, C., Swami, N., Krzyzanowska, M., Hannon, B., Leighl, N., Oza, A., Moore, M., Rydall, A., Rodin, G., Tannock, I., Donner, A., & Lo, C. (2014). Early palliative care for patients with advanced cancer: A cluster-randomised controlled trial. The Lancet, 383(9930), 1721–1730. https://doi.org/10.1016/s0140-6736(13)62416-2
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