Academic Center for General Practice, K.U.Leuven, Belgium.
Palliat Med. 2013 Mar;27(3):197-208. doi: 10.1177/0269216311435268. Epub 2012 Feb 6.
The lack of a clear definition of the palliative care patient hampers the comparison of results across different studies and impedes implementation of research findings in everyday practice.
The aim of this article is to propose minimum characteristics that define a palliative care patient.
The design involved a systematic review of medical literature searching randomised controlled trials (RCTs) in palliative care for clear descriptions of their palliative care patients. We systematically describe relevant characteristics of the study populations of 60 eligible RCTs.
The data sources used were MEDLINE, EMBASE, CINAHL, and PSYCHINFO, including all non-cancer RCTs (1 January 1995-4 March 2010) and an equivalent number of the most recent cancer RCTs (1 January 2003-4 March 2010).
Half of the non-cancer studies were excluded because they did not relate to palliative care. We conclude that published RCTs have no clear definitions of their palliative care patients and illustrate the diversity of this patient, the lack of consensus concerning the attributes of illnesses needing palliation and the ambiguous use of the adjective 'palliative'.
We propose elements of the patients' health status (e.g. a progressive, life-threatening disease with no possibility of obtaining remission or stabilisation, or modifying the course of the illness) and the care delivered to them (e.g. a holistic interdisciplinary approach that focuses on supporting the quality of the end of life) to be included in the definition of a palliative care patient. We also suggest considering the patients' readiness to accept palliative care and a vision of palliative care shared by the patient and all caregivers involved as potentially important elements in this definition.
缺乏对姑息治疗患者的明确定义，阻碍了不同研究结果的比较，并妨碍了研究结果在日常实践中的实施。
本文旨在提出定义姑息治疗患者的最低特征。
本研究采用系统综述方法，检索姑息治疗中的随机对照试验（RCT），以明确描述其姑息治疗患者。我们系统地描述了 60 项符合条件的 RCT 研究人群的相关特征。
使用的资料来源包括 MEDLINE、EMBASE、CINAHL 和 PSYCHINFO，包括所有非癌症 RCT（1995 年 1 月 1 日至 2010 年 3 月 4 日）和最近的癌症 RCT（2003 年 1 月 1 日至 2010 年 3 月 4 日）的同等数量。
一半的非癌症研究被排除在外，因为它们与姑息治疗无关。我们得出的结论是，已发表的 RCT 对其姑息治疗患者没有明确的定义，并说明了这类患者的多样性，对需要姑息治疗的疾病的属性缺乏共识，以及形容词“姑息”的使用含糊不清。
我们提出了患者健康状况的要素（例如，一种进行性、危及生命的疾病，没有缓解或稳定的可能性，或改变疾病的进程）和对他们提供的护理（例如，一种整体的多学科方法，侧重于支持生命末期的质量）应包括在姑息治疗患者的定义中。我们还建议考虑患者接受姑息治疗的准备情况，以及患者和所有相关护理人员对姑息治疗的共同看法，作为该定义中的潜在重要要素。
