End-of-Life Care Research Group, Ghent University & Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, 1090, Belgium.
BMC Palliat Care. 2013 Feb 8;12:6. doi: 10.1186/1472-684X-12-6.
In recent years, there have been several studies, using a wide variety of methods, aimed at developing quality indicators for palliative care. In this Quality Indicators for Palliative Care study (Q-PAC study) we have applied a scientifically rigorous method to develop a comprehensive and valid quality indicator set which can contribute to a standardized method for use in other countries.
Firstly, an extensive literature review identified existing international quality indicators and relevant themes for measuring quality in palliative care. Secondly, the most relevant of these were selected by an expert panel. Thirdly, those prioritized by the experts were scored by a second multidisciplinary expert panel for usability and relevance, in keeping with the RAND/UCLA-method, combining evidence with consensus among stakeholders. This panel included carers and policymakers as well as patients and next-of-kin. Fourthly, the draft set was tested and evaluated in practice for usability and feasibility; the indicators were then translated into questionnaires presented to patients, next-of-kin and care providers. To encourage the acceptance and use of the indicators, stakeholders, including national palliative care organizations, were involved throughout the whole project.
Our indicator development trajectory resulted in a set of quality indicators applicable to all patients in all palliative care settings. The set includes patient and relative perspectives and includes outcome, process and structure indicators. Our method can contribute internationally to a more standardized and rigorous approach to developing quality indicators for palliative care.
近年来，已有多项研究采用各种方法，旨在为姑息治疗制定质量指标。在这项姑息治疗质量指标研究（Q-PAC 研究）中，我们应用了科学严谨的方法来制定一套全面有效的质量指标集，以有助于在其他国家采用标准化方法。
首先，通过广泛的文献回顾，确定了现有的国际质量指标和姑息治疗质量测量的相关主题。其次，由专家组选择其中最相关的指标。第三，由第二个多学科专家组根据可用性和相关性对专家优先考虑的指标进行评分，符合 RAND/UCLA 方法，将证据与利益相关者的共识相结合。该小组包括护理人员和政策制定者以及患者和近亲。第四，对草案进行了实际测试和评估，以评估其可用性和可行性；然后将指标翻译成问卷，分发给患者、近亲护理人员和提供者。为了鼓励利益相关者接受和使用这些指标，包括国家姑息治疗组织在内的利益相关者都参与了整个项目。
我们的指标制定轨迹产生了一套适用于所有姑息治疗环境中所有患者的质量指标。该套件包括患者和亲属的观点，并包括结果、过程和结构指标。我们的方法可以为姑息治疗质量指标的制定提供国际上更标准化和严格的方法。
