Department of Medical Oncology, Erasmus MC Rotterdam, The Netherlands.
J Palliat Med. 2012 Mar;15(3):308-16. doi: 10.1089/jpm.2011.0393. Epub 2012 Feb 10.
Quality indicators (QIs) are needed to monitor and to improve palliative care. Care of patients in the last days of life is a discrete phase of palliative care and therefore specific QIs are needed. This study aimed to identify and evaluate current QIs against which to measure future care of patients in the last days of life.
To identify QIs for patients in the last days of life an update of the literature and national guidelines was conducted. Subsequently, an international panel of palliative care experts was asked to evaluate the identified QIs: how well they describe care and how applicable they are for care in the last days of life. Also additional QIs were asked.
In total, 34 QIs for care in the last days were identified in the literature and guidelines. The experts (response rate 58%) agreed with seven QIs as being good descriptors and applicable: concerning a home visit for the family following a patient's death, the presence of a dedicated family room, limited patients receiving chemotherapy, limited need for pain control, gastrointestinal symptoms, and communication from professional to patient and family. The experts also suggested 18 additional topics for QIs for the last days of life.
Currently no definite set of QIs exist to describe quality of care of patients in their last days of life. New QIs that are focused on care for patients in their last days of life, their relatives, as well as their professional caregivers are needed.
质量指标（QIs）是监测和改善姑息治疗所必需的。生命末期患者的护理是姑息治疗的一个独特阶段，因此需要特定的 QIs。本研究旨在确定和评估当前的 QIs，以衡量生命末期患者的未来护理。
为了确定生命末期患者的 QIs，对文献和国家指南进行了更新。随后，要求一个国际姑息治疗专家小组评估确定的 QIs：它们在多大程度上描述了护理，以及它们在生命末期的护理中的适用性。还要求了其他的 QIs。
总共在文献和指南中确定了 34 项生命末期护理的 QIs。专家（回应率为 58%）同意将七个 QIs 视为良好的描述符和适用的指标：包括在患者死亡后对家属进行家访、提供专门的家庭病房、接受化疗的患者人数有限、对疼痛控制的需求有限、胃肠道症状以及专业人员与患者和家属的沟通。专家还建议了 18 个额外的生命末期 QIs 主题。
目前尚无明确的 QIs 集来描述生命末期患者的护理质量。需要新的 QIs，这些 QIs 专注于生命末期患者、他们的亲属以及他们的专业护理人员的护理。
