Lind Susanne, Adolfsson Jan, Axelsson Bertil, Fürst Carl Johan
Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden.
BMJ Support Palliat Care. 2013 Jun;3(2):174-80. doi: 10.1136/bmjspcare-2012-000390. Epub 2013 Mar 7.
All patients with palliative and end of life care needs should be guaranteed equal and safe treatment and care, regardless of their disease or site of care. The inclusion of quality indicators in national guidelines and other guiding documents supports quality assurance and improvement in provision of care. The aim of this paper was to review existing quality indicators in national Swedish policy documents relevant to palliative and end of life care.
We reviewed existing guidelines for diseases expected to require palliative care issued by the National Board of Health and Welfare, existing regional clinical practice guidelines and the annual report of the Swedish Register of Palliative Care (SRPC) up until 2010.
We found 11 quality indicators pertinent to palliative and end of life care in the guidelines for cancer diseases and 'The care and nursing of the elderly'. The indicators included assessment and treatment of pain, communication with the patient and the family, documentation in the patient record and registration in the SRPC. In the national guidelines for cardiology, pulmonary diseases, stroke, diabetes and dementia, there were no indicators relevant for palliative or end of life care.
In the existing Swedish national guidelines for many different diseases, there is still a great need to define clinically relevant and feasible outcome measures of quality of palliative and end of life care.
所有有姑息治疗和临终关怀需求的患者都应获得平等且安全的治疗与护理，无论其疾病状况或护理地点如何。在国家指南及其他指导文件中纳入质量指标有助于保障和提高护理质量。本文旨在回顾瑞典国家政策文件中与姑息治疗和临终关怀相关的现有质量指标。
我们回顾了瑞典国家卫生与福利委员会发布的针对预计需要姑息治疗的疾病的现有指南、现有的地区临床实践指南以及截至2010年的瑞典姑息治疗登记处（SRPC）年度报告。
我们在癌症疾病指南和“老年人护理与照料”中发现了11项与姑息治疗和临终关怀相关的质量指标。这些指标包括疼痛评估与治疗、与患者及家属的沟通、病历记录以及在SRPC中的登记。在心脏病、肺病、中风、糖尿病和痴呆症的国家指南中，没有与姑息治疗或临终关怀相关的指标。
在瑞典现有的针对多种不同疾病的国家指南中，仍然非常需要定义与姑息治疗和临终关怀质量相关的临床相关且可行的结果指标。
