Devery K, Lennie I, Cooney N
Palliative Care Research Unit, School of Medicine, Flinders University of South Australia.
J Palliat Care. 1999 Summer;15(2):5-12.
Health outcomes are being promoted as a necessary evaluation measure in health care services. Less often discussed is the notion that health outcomes are artificially designated endpoints and that different people in the health system have different ideas of what the outcomes ought to be. Whose evidence is acceptable and relevant in constructing a framework of health outcomes in palliative care? This paper presents the findings of a research project undertaken in New South Wales, Australia, on health outcomes as evaluated by patients and caregivers. A wide range of health care professionals also participated. Patients and caregivers valued outcomes or endpoints in palliative care that were not necessarily brought about by expert clinical intervention. By adopting too narrow an interpretation of outcomes we risk sacrificing that which is uniquely valuable in palliative care services.
健康结果正被作为医疗服务中一项必要的评估指标加以推广。但较少被讨论的是这样一种观念，即健康结果是人为设定的终点，而且医疗系统中的不同人员对于结果应该是什么有着不同的看法。在构建姑息治疗的健康结果框架时，谁的证据是可接受且相关的呢？本文呈现了在澳大利亚新南威尔士州开展的一个关于患者和照护者所评估的健康结果的研究项目的结果。众多医疗保健专业人员也参与其中。患者和照护者重视姑息治疗中的结果或终点，而这些结果不一定是由专家临床干预带来的。如果对结果的解释过于狭隘，我们就有可能牺牲姑息治疗服务中独特的宝贵之处。
