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为什么高质量的姑息治疗研究如此难以开展?基于姑息治疗研究人员调查的研究改进障碍。

Why is high-quality research on palliative care so hard to do? Barriers to improved research from a survey of palliative care researchers.

作者信息

Chen Emily K, Riffin Catherine, Reid M Cary, Adelman Ronald, Warmington Marcus, Mehta Sonal S, Pillemer Karl

机构信息

1 Department of Human Development, Cornell University , Ithaca, New York.

出版信息

J Palliat Med. 2014 Jul;17(7):782-7. doi: 10.1089/jpm.2013.0589. Epub 2014 Jun 2.

Abstract

BACKGROUND

Substantial agreement has been achieved on research priorities in palliative care over the past 15 years, as evidenced by consensus conferences and systematic reviews. Despite the presence of a widely endorsed research agenda, however, addressing the gaps in scientific knowledge has progressed slowly, suggesting that researchers face significant obstacles to conducting high-quality research on the most pressing topics in the field.

OBJECTIVE

To systematically identify barriers to improved and expanded palliative care research as reported by researchers.

DESIGN

Semistructured telephone interviews to solicit barriers to research in palliative care.

SETTING/SUBJECTS: A purposive, interdisciplinary sample of 61 leading researchers in palliative care.

MEASUREMENTS

Interviews were transcribed and analyzed using standard qualitative methods.

RESULTS

Respondents named five barriers impeding progress: (1) funding, (2) institutional capacity, (3) researcher workforce, (4) challenges related to the topic and population (e.g., attrition, heightened human subjects protections), and (5) public and professional misunderstanding of palliative care and aversion to topics related to serious illness and end-of-life.

CONCLUSIONS

Research in palliative care is being held back by significant barriers that require the attention of institutions and funders. The consensus within the interdisciplinary sample indicates that concentrated effort to address barriers related to funding and researcher workforce could facilitate progress on established research priorities. More research is needed on viable strategies for overcoming the identified barriers.

摘要

背景

在过去15年里,姑息治疗的研究重点已达成广泛共识,共识会议和系统评价证明了这一点。然而,尽管存在广泛认可的研究议程,但在填补科学知识空白方面进展缓慢,这表明研究人员在就该领域最紧迫的课题开展高质量研究时面临重大障碍。

目的

系统识别研究人员报告的改善和扩大姑息治疗研究的障碍。

设计

采用半结构化电话访谈以获取姑息治疗研究的障碍。

设置/对象:从姑息治疗领域有目的地选取61位顶尖研究人员组成跨学科样本。

测量

访谈内容转录后采用标准定性方法进行分析。

结果

受访者指出了阻碍进展的五个障碍:(1)资金;(2)机构能力;(3)研究人员队伍;(4)与课题和人群相关的挑战(如人员流失、加强对人体受试者的保护);(5)公众和专业人士对姑息治疗的误解以及对与严重疾病和临终相关课题的反感。

结论

姑息治疗研究受到重大障碍的阻碍,这些障碍需要机构和资助者予以关注。跨学科样本中的共识表明,集中精力解决与资金和研究人员队伍相关的障碍有助于在既定研究重点上取得进展。需要开展更多研究以探寻克服已识别障碍的可行策略。

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