King Nigel, Thomas Keri, Bell Dennise
Primary Care Research Group, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield HD1 3DH, UK.
Int J Palliat Nurs. 2003 Jul;9(7):277-82. doi: 10.12968/ijpn.2003.9.7.17120.
Much of palliative care takes place in the patient's home. Out-of-hours service provision can be an area of concern. With the aim of improving this service, the former Calderdale and Kirklees Health Authority introduced an out-of-hours protocol for palliative care in the community. After 1 year the authors examined the experiences of primary care practitioners in using the protocol. Twenty district nurses and 15 GPs from 25 general practices in Calderdale, Huddersfield and North Kirklees took part in the study, which involved face-to-face group and individual telephone interviews. Practitioners felt that the out-of-hours protocol had made a positive contribution to palliative care in the community and that the out-of-hours handover form played a key role in improving communications and the coordination of services. For many participants, the protocol encouraged a more anticipatory approach to care and enabled better access to drugs and to specialist advice. The main areas of concern related to updating patient information on the handover forms, and to shortcomings in the support offered to carers. Future developments should address these issues. Although recognizing the dangers of generalization from research of this type, the findings offer encouragement to others considering similar schemes.
姑息治疗大多在患者家中进行。非工作时间的服务提供可能是一个令人担忧的领域。为了改善这项服务，前考尔德代尔和柯克利斯卫生局推出了一项社区姑息治疗非工作时间协议。1年后，作者考察了基层医疗从业者使用该协议的经验。来自考尔德代尔、哈德斯菲尔德和北柯克利斯25家全科诊所的20名 district nurses（地区护士）和15名全科医生参与了这项研究，研究包括面对面小组访谈和个人电话访谈。从业者认为，非工作时间协议对社区姑息治疗做出了积极贡献，非工作时间交接表在改善沟通和服务协调方面发挥了关键作用。对许多参与者来说，该协议鼓励了更具前瞻性的护理方法，并使患者能更好地获取药物和专家建议。主要担忧的领域涉及在交接表上更新患者信息，以及对护理人员提供的支持存在不足。未来的发展应解决这些问题。尽管认识到从这类研究进行概括存在风险，但这些发现为其他考虑类似方案的人提供了鼓励。
