Background: Under the background of the increasing aging population and cancer burden in China, the role of hospice care has become increasingly prominent. The government has paid more attention to the development of hospice care and set up pilot hospitals to promote hospice care. Moreover, healthcare providers play a leading role in hospice care services. To improve the quality of hospice care, the National Health Commission of the People's Republic of China proposed to set up hospice care training bases in municipal or above-level hospitals with hospice care or relevant work foundations, and train healthcare providers on hospice care. This study aimed to investigate the current situation of cognition and attitudes about hospice care among healthcare providers and provide a theoretical basis for hospital training. Methods: We used a quantitative design. A questionnaire survey was conducted among 1591 healthcare providers from August 2022 to November 2022. SPSS 22.0 software was used to analyze the data. Results: As a significant way of continuing education for healthcare providers, hospital training hasn't been effectively exploited in hospice care education. The average score of hospice care knowledge among participants was (7.74±2.242) and the average score of hospice care attitudes among participants was (4.55±1.503). According to multivariate linear regression analysis, sex (P<0.001), education levels (P<0.001), and professional titles (P=0.002) of participants had significant difference on the score of hospice care knowledge; education levels (P=0.046) and professional titles (P=0.020) of participants had significant difference on the score of hospice care attitudes. Conclusions: There were some misunderstandings about hospice care among healthcare providers and their attitudes toward hospice care were inactive. It's suggested that hospitals should carry out professional and systematic education courses to help healthcare providers understand hospice care correctly, and participate in hospice care services actively.

Background and PurposeIndex cholecystectomy is insufficient for curing T3 incidental gallbladder cancer (IGC), and once residual cancer (RC) is found, the prognosis is often poor. The purpose of this study was to investigate the effect of RC on the prognosis and the optimal choice of adjuvant therapy for R0 reresection patients with T3 IGC.MethodsWe retrospectively reviewed data from patients with T3 IGC who underwent radical reresection from January 2013 to December 2018. RC was defined as histologically proven cancer at reresection. Demographics and tumour treatment-related variables were analysed in correlation with RC and survival. Adjuvant (Adj) chemoradiotherapy (CRT) was correlated with overall survival (OS) and disease-free survival (DFS).ResultsOf the 167 patients with IGC who underwent surgery, 102 underwent radical extended resection. Thirty-two (31.4%) RCs were found. Hepatic side tumours (T3h) and both side tumours (T3h+T3p) were associated with the presence of RC. In multivariate analysis, RC and lymph node metastasis were independent prognostic factors for DFS and OS (P <0.05). RC was associated with a significantly shorter median OS (20 vs. 53 months; P<0.01) and DFS (11 vs. 40 months; P<0.001) despite R0 resection. For R0 reresection patients with RC and/or lymph node metastasis, Adj CRT significantly improved OS (P=0.024).ConclusionResidual cancer and lymphatic metastasis are important factors for the poor prognosis of T3 IGC despite R0 resection, and these patients should actively receive adjuvant therapy.

Background and purpose Index cholecystectomy is insufficient for curing T3 incidental gallbladder cancer (IGC), and once residual cancer (RC) is found, the prognosis is often poor. The purpose of this study was to investigate the effect of RC on the prognosis and the optimal choice of adjuvant therapy for R0 reresection patients with T3 IGC. Methods We retrospectively reviewed data from patients with T3 IGC who underwent radical reresection from January 2013 to December 2018. RC was defined as histologically proven cancer at reresection. Demographics and tumour treatment-related variables were analysed in correlation with RC and survival. Adjuvant (Adj) chemoradiotherapy (CRT) was correlated with overall survival (OS) and disease-free survival (DFS). Results Of the 167 patients with IGC who underwent surgery, 102 underwent radical extended resection. Thirty-two (31.4%) RCs were found. Hepatic side tumours (T3h) and both side tumours (T3h + T3p) were associated with the presence of RC. In multivariate analysis, RC and lymph node metastasis were independent prognostic factors for DFS and OS (P < 0.05). RC was associated with a significantly shorter median OS (20 vs. 53 months; P < 0.01) and DFS (11 vs. 40 months; P < 0.001) despite R0 resection. For R0 reresection patients with RC and/or lymph node metastasis, Adj CRT significantly improved OS (P = 0.024). Conclusion Residual cancer and lymphatic metastasis are important factors for the poor prognosis of T3 IGC despite R0 resection, and these patients should actively receive adjuvant therapy.