确定医院整合姑息关怀方法的核心指标:国际德尔菲研究。

IF 3.6 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES
Mary Nevin, Sheila Payne, Valerie Smith
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引用次数: 0

摘要

背景:在医院工作的医疗服务提供者经常接触到有姑息关怀需求的病人。对于许多病人来说,这些需求往往反映的是非专科而非专科姑息关怀的需求。然而,将姑息关怀纳入急症医院的医疗服务中却具有挑战性。目的:确定医院整合姑息关怀的核心指标:设计:采用德尔菲(Delphi)技术,连续进行三轮在线调查。通过对姑息关怀方法的概念分析以及对医院医疗服务提供者对姑息关怀方法看法的系统回顾,确定了初步指标:由三个主要利益相关群体(临床医生、研究人员、患者/家属)组成的国际专家小组参与了每轮德尔菲讨论:德尔菲参与者来自 12 个国家;第一轮有 97 人回应,第二轮有 78 人回应,第三轮有 72 人回应(总回应率为 74%)。就医院姑息关怀方法的 32 项核心指标达成了共识(先验定义为 >70%),其中包括 5 项结构指标(与基础设施和治理有关)、21 项组织指标(与临床关怀流程有关)和 6 项员工指标(与医护人员的培训和支持有关):本研究基于主要利益相关群体的证据和国际共识,为医院整合姑息关怀方法的临床实践、政策和研究提供了多层次的指导。这些核心指标为评估、审查和交流医院姑息关怀方法的核心要素提供了一种手段。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Identification of core indicators for the integration of a palliative care approach in hospitals: An international Delphi study.

Background: Healthcare providers working in hospitals have significant exposure to patients with palliative care needs. For many patients, these needs often reflect non-specialist rather than specialist palliative care needs. Embedding a palliative care approach in acute hospital-based care however is challenging.

Aim: To identify core indicators for the integration of a palliative care approach in hospitals.

Design: A Delphi technique used three sequential online survey rounds. Preliminary indicators were identified in a concept analysis of a palliative care approach, and a systematic review of hospital-based healthcare providers' views of a palliative care approach.

Participants: An international expert panel of three key stakeholder groups (clinicians, researchers, patients/family members) participated in each Delphi round.

Results: The Delphi participants were recruited from 12 countries; 97 individuals responded to round 1, 78 to round 2 and 72 to round 3 (74% overall response rate). Consensus was achieved (defined a priori as >70%) on 32 core indicators of a hospital-based palliative care approach, with five structural indicators (relating to infrastructure and governance), 21 organisational indicators (relating to clinical care processes) and six staff indicators (relating to training and support for healthcare providers).

Conclusions: This study offers multi-level guidance for clinical practice, policy and research related to integration of a palliative care approach in hospitals, based on evidence and international consensus from major stakeholder groups. These core indicators provide a means to assess, review and communicate the core elements of a palliative care approach in hospitals.

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来源期刊
Palliative Medicine
Palliative Medicine 医学-公共卫生、环境卫生与职业卫生
CiteScore
7.60
自引率
9.10%
发文量
125
审稿时长
6-12 weeks
期刊介绍: Palliative Medicine is a highly ranked, peer reviewed scholarly journal dedicated to improving knowledge and clinical practice in the palliative care of patients with far advanced disease. This outstanding journal features editorials, original papers, review articles, case reports, correspondence and book reviews. Essential reading for all members of the palliative care team. This journal is a member of the Committee on Publication Ethics (COPE).
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