Reilly Charles C, Bausewein Claudia, Pannell Caty, Moxham John, Jolley Caroline J, Higginson Irene J
Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK
Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK Department for Palliative Medicine, Munich University Hospital, Munich, Germany.
Palliat Med. 2016 Mar;30(3):313-22. doi: 10.1177/0269216315600103. Epub 2015 Aug 26.
We developed a new single point of access to integrated palliative care, respiratory medicine and physiotherapy: the breathlessness support service for patients with advanced disease and refractory breathlessness. This study aimed to describe patients' experiences of the service and identify the aspects valued.
We attempted to survey all patients who had attended and completed the 6-week breathlessness support service intervention by sending them a postal questionnaire to self-complete covering experience, composition, effectiveness of the BSS and about participation in research. Data were analysed using descriptive statistics and thematic analysis of free text comments.
Of the 70 postal questionnaires sent out, 25 (36%) returned. A total of 21 (84% (95% confidence interval: 69%-98%)) responding patients reported that they definitely found the breathlessness support service helpful and 13 (52% (95% confidence interval: 32%-72%)) rated the breathlessness support service as excellent. A total of 21 (84% (95% confidence interval: 69%-98%)) patients reported that the breathlessness support service helped with their management of their breathlessness along with additional symptoms and activities (e.g. mood and mobility). Four key themes were identified: (1) personalised care, (2) caring nature of the staff, (3) importance of patient education to empower patients and (4) effectiveness of context-specific breathlessness interventions. These were specific aspects that patients valued.
Patients' satisfaction with the breathlessness support service was high, and identified as important to this was a combination of personalised care, nature of staff, education and empowerment, and use of specific interventions. These components would be important in any future breathlessness service.
我们开发了一种新的综合姑息治疗、呼吸医学和物理治疗的单点接入服务:针对晚期疾病和难治性呼吸困难患者的呼吸困难支持服务。本研究旨在描述患者对该服务的体验,并确定他们重视的方面。
我们试图通过向所有参加并完成为期6周的呼吸困难支持服务干预的患者发送邮政问卷,让他们自行填写有关体验、服务构成、呼吸困难支持服务的有效性以及参与研究的情况。使用描述性统计和对自由文本评论的主题分析来分析数据。
在发出的70份邮政问卷中,25份(36%)被退回。共有21名(84%(95%置信区间:69%-98%))回复的患者报告说他们肯定发现呼吸困难支持服务有帮助,13名(52%(95%置信区间:32%-72%))将呼吸困难支持服务评为优秀。共有21名(84%(95%置信区间:69%-98%))患者报告说呼吸困难支持服务有助于他们管理呼吸困难以及其他症状和活动(如情绪和行动能力)。确定了四个关键主题:(1)个性化护理,(2)工作人员的关怀性质,(3)患者教育对增强患者能力的重要性,(4)针对特定情况的呼吸困难干预措施的有效性。这些是患者重视的具体方面。
患者对呼吸困难支持服务的满意度很高,他们认为个性化护理、工作人员的性质、教育和赋权以及使用特定干预措施的结合对此很重要。这些组成部分在未来的任何呼吸困难服务中都将很重要。