经 PAMINO 培训的和其他全科医生在家中照顾的姑息治疗患者 - 用 QLQ-C15-PAL 和 POS 测量的健康相关生活质量。
Palliative patients cared for at home by PAMINO-trained and other GPs - health-related quality of life as measured by QLQ-C15-PAL and POS.
机构信息
Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany.
出版信息
BMC Palliat Care. 2012 Aug 21;11:13. doi: 10.1186/1472-684X-11-13.
BACKGROUND
To maintain patients' quality of life is one of the major goals in palliative home care provided by general practitioners (GPs). GPs need adequate training to care for palliative patients. The paper seeks to evaluate whether a specific training in Germany (PAMINO) has any improving impact on the care of palliative patients and their health-related quality of life.
METHODS
From September 2007 until June 2009, GPs and their palliative care patients with cancer participated in a study to evaluate palliative courses for GPs offered by a regional palliative care initiative (PAMINO). For a period of six months at most or until death, patients were asked monthly to judge their quality of life on the Quality of Life Questionnaire Core 15 Palliative (QLQ-C15-PAL) of the European Organization for Research and Treatment of Cancer (EORTC) and on the Palliative Care Outcome Scale (POS). The 'Overall quality of life' scale of the QLQ-C15-PAL takes values between 0 and 100 with higher values indicating a higher quality of life. The POS sum scale takes values between 0 and 40 with higher values indicating worse care outcomes. Patients cared for by PAMINO-trained GPs and patients cared for by other GPs (control group) are compared using t-tests for differences in group means.
RESULTS
One hundred patients participated in the study; 96 patients filled out the questionnaires at least once. On the QLQ-C15-PAL, mean quality of life of the patient groups of PAMINO-trained and other GPs were 37.7 (SD = 25.5) and 39.4 (SD = 26.3) (p = .76), respectively. On the POS, respective mean values of 13.6 (SD = 5.8) and 12.0 (SD = 6.5) (p = .26) were given. Patients cared for by a PAMINO-trained GP did not report better quality of life and care outcomes than patients cared for by other general practitioners.
CONCLUSIONS
Patients cared for by PAMINO-trained and other GPs in our study did not report differences in quality of life. Quality of life and care outcomes of all patients were better than of palliative patients in institutional or specialized care, emphasizing the ability of GPs to provide adequate care for these vulnerable patients. However, conclusions need to be drawn cautiously since the study had a small sample size.
TRIAL REGISTRATION
Current Controlled Trials ISRCTN78021852.
背景
在全科医生（GP）提供的姑息治疗中，维持患者的生活质量是主要目标之一。GP 需要接受足够的培训以照顾姑息治疗患者。本文旨在评估德国（PAMINO）的一项特定培训是否对姑息治疗患者的护理及其健康相关生活质量有任何改善作用。
方法
从 2007 年 9 月至 2009 年 6 月，GP 及其患有癌症的姑息治疗患者参加了一项研究，以评估区域姑息治疗倡议（PAMINO）为 GP 提供的姑息治疗课程。在最多 6 个月或直至死亡的时间内，患者每月被要求使用欧洲癌症研究与治疗组织（EORTC）的姑息治疗核心问卷 15 项（QLQ-C15-PAL）和姑息治疗结局量表（POS）来判断他们的生活质量。QLQ-C15-PAL 的“整体生活质量”量表的取值范围在 0 到 100 之间，得分越高表示生活质量越高。POS 总分的取值范围在 0 到 40 之间，得分越高表示护理结果越差。使用 t 检验比较接受 PAMINO 培训的 GP 照顾的患者和接受其他 GP（对照组）照顾的患者的组间均值差异。
结果
共有 100 名患者参加了研究；96 名患者至少填写了一次问卷。在 QLQ-C15-PAL 上，接受 PAMINO 培训的 GP 组和其他 GP 组患者的平均生活质量分别为 37.7（SD=25.5）和 39.4（SD=26.3）（p=0.76）。在 POS 上，分别给出了 13.6（SD=5.8）和 12.0（SD=6.5）的平均值（p=0.26）。接受 PAMINO 培训的 GP 照顾的患者在生活质量和护理结果方面并不比其他全科医生照顾的患者报告更好。
结论
在我们的研究中，接受 PAMINO 培训的 GP 和其他 GP 照顾的患者在生活质量方面没有报告差异。所有患者的生活质量和护理结果都优于机构或专业护理中的姑息治疗患者，这强调了 GP 为这些脆弱患者提供足够护理的能力。然而，由于研究样本量较小，因此需要谨慎得出结论。
试验注册
当前对照试验 ISRCTN78021852。
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