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患者和照护者所体验的专科门诊姑息治疗服务的效果。

Effectiveness of a specialized outpatient palliative care service as experienced by patients and caregivers.

机构信息

Pediatric Palliative Care Service, Dr. von Haunersches Kinderspital, Ludwig-Maximilians-University, Munich, Germany.

出版信息

J Palliat Med. 2013 Aug;16(8):848-56. doi: 10.1089/jpm.2012.0491. Epub 2013 May 16.

Abstract

OBJECTIVES

In Germany since 2007 patients with advanced life-limiting diseases are eligible for Specialized Outpatient Palliative Care (SOPC). To provide this service, SOPC teams have been established as a new facility in the health care system. The objective of this study was to evaluate the effectiveness of one of the first SOPC teams based at the Munich University Hospital.

METHODS

All patients treated by the SOPC team and their primary caregivers were eligible for this prospective nonrandomized study. The main topics of the surveys before and after involvement of the SOPC team were: for patients, the assessment of symptom burden (Minimal Documentation System for Palliative Medicine, MIDOS), satisfaction with quality of palliative care (Palliative Outcome Scale, POS), and quality of life (McGill Quality of Life Questionnaire, MQOL); for caregivers, burden of care (Häusliche Pflegeskala, home care scale, HPS), anxiety and depression (Hospital Anxiety and Depression Scale, HADS), and quality of life (Quality of Life in Life-Threatening Illness-Family Carer Version, QOLLTI-F).

RESULTS

Of 100 patients treated between April and November 2011, 60 were included in the study (median age 67.5 years, 55% male, 87% oncological diseases). In 23 of 60 patients, only caregivers could be interviewed. The median interval between the first and second interview was 2.5 weeks. Quality of life increased significantly in patients (p<0.05) and caregivers (p<0.001), as did the patients' perception of quality of palliative care (POS, p<0.001), while the caregivers' psychological distress and burden of care significantly decreased (HADS, p<0.001; HPS, p<0.001).

CONCLUSIONS

The involvement of an SOPC team leads to a significant improvement in the quality of life of patients and caregivers and can lower the burden of home care for the caregivers of severely ill patients.

摘要

目的

自 2007 年以来,德国的晚期绝症患者有资格获得专门的门诊姑息治疗(SOPC)。为了提供这项服务,SOPC 团队已作为医疗保健系统中的一项新设施成立。本研究的目的是评估慕尼黑大学医院的第一个 SOPC 团队之一的有效性。

方法

所有接受 SOPC 团队治疗的患者及其主要护理人员都有资格参加这项前瞻性非随机研究。在 SOPC 团队介入前后的调查的主要主题是:对于患者,症状负担评估(姑息治疗最低限度文档系统,MIDOS),对姑息治疗质量的满意度(姑息治疗结果量表,POS)和生活质量(麦吉尔生活质量问卷,MQOL);对于护理人员,照顾负担(家庭护理量表,HPS),焦虑和抑郁(医院焦虑和抑郁量表,HADS),以及生活质量(危及生命疾病家庭护理者生活质量问卷版本,QOLLTI-F)。

结果

在 2011 年 4 月至 11 月期间治疗的 100 名患者中,有 60 名患者入组(中位年龄 67.5 岁,55%为男性,87%为肿瘤疾病)。在 60 名患者中,只有 23 名护理人员可以接受采访。第一次和第二次采访之间的中位数间隔为 2.5 周。患者(p<0.05)和护理人员(p<0.001)的生活质量显着提高,患者对姑息治疗质量的感知(POS,p<0.001)也提高了,而护理人员的心理困扰和照顾负担显着减轻(HADS,p<0.001; HPS,p<0.001)。

结论

SOPC 团队的参与可显着提高患者和护理人员的生活质量,并降低重病患者护理人员的家庭护理负担。

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