Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
J Pain Symptom Manage. 2013 Oct;46(4):556-72. doi: 10.1016/j.jpainsymman.2012.09.013. Epub 2013 Jun 26.
In 2007, a systematic review revealed a number of quality indicators referring mostly to palliative care outcomes and processes. Psychosocial and spiritual aspects were scarcely represented. Most publications lacked a detailed description of the development process. With many initiatives and further developments expected, an update is needed.
This update gives an overview of the published quality indicators for palliative care and identifies any new developments since 2007 regarding the number and type of indicators developed and the methodology applied.
The same literature search as in the 2007 review was used to identify relevant publications up to October 2011. Publications describing development processes or characteristics of quality indicators for palliative care were selected by two reviewers independently.
The literature search resulted in 435 hits in addition to the 650 hits found in the previous review. Thirteen new publications were selected in addition to the 16 publications selected earlier, describing 17 sets of quality indicators containing 326 indicators. These cover all domains of palliative care as defined by the U.S. National Consensus Project. Most indicators refer to care processes or outcomes. The extent to which methodological characteristics are described varies widely.
Recent developments in measuring quality of palliative care using quality indicators are mainly quantitative in nature, with a substantial number of new indicators being found. However, the quality of the development process varies considerably between sets. More consistent and detailed methodological descriptions are needed for the further development of these indicators and improved quality measurement of palliative care.
2007 年，一项系统评价揭示了许多主要涉及姑息治疗结果和过程的质量指标。心理社会和精神方面的指标几乎没有涉及。大多数出版物缺乏对开发过程的详细描述。随着许多举措和进一步的发展，需要进行更新。
本更新概述了姑息治疗的已发表质量指标，并确定了自 2007 年以来在开发的指标数量和类型以及应用的方法学方面的任何新进展。
使用与 2007 年评价相同的文献检索来确定截至 2011 年 10 月的相关出版物。由两位评审员独立选择描述姑息治疗质量指标开发过程或特征的出版物。
除了之前评价中发现的 650 篇文献外，文献检索还额外产生了 435 篇文献。除了早些时候选择的 16 篇文献外，又有 13 篇新的文献被选中，描述了 17 套姑息治疗质量指标，其中包含 326 个指标。这些指标涵盖了美国国家共识项目定义的姑息治疗的所有领域。大多数指标涉及护理过程或结果。方法学特征的描述程度差异很大。
使用质量指标衡量姑息治疗质量的最新进展主要是定量的，发现了大量新的指标。然而，各套指标的开发过程质量差异很大。需要更一致和详细的方法学描述，以进一步发展这些指标，并改善姑息治疗的质量测量。
