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[物理治疗在临终关怀与姑息治疗中的整合与应用:德国临床实践调查]

[Integration and utilization of physiotherapy in hospice and palliative care : A survey on clinical practice in Germany].

作者信息

Woitha K, Schneider N, Wünsch A, Wiese B, Fimm S, Müller-Mundt G

机构信息

Institut für Allgemeinmedizin, Arbeitsgruppe Palliativversorgung, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.

Physiotherapie und Physikalische Therapie, Campus Kiel, Universitätsklinikum Schleswig-Holstein (UKSH), Kiel, Deutschland.

出版信息

Schmerz. 2017 Feb;31(1):62-68. doi: 10.1007/s00482-016-0151-4.

DOI:10.1007/s00482-016-0151-4
PMID:27655409
Abstract

BACKGROUND

Palliative care is an approach that improves the quality of life of patients with incurable and progressive illnesses; therefore, in these situations physiotherapy can play an important role.

AIM

This study was carried out to examine the integration and utilization of physiotherapy in palliative and hospice care services in Germany.

METHODS

A cross-sectional survey including all palliative care units, specialized outpatient palliative care teams and hospices in Germany (n = 680) in 2013 was carried out.

RESULTS

The response rate was 43.5 % (n = 296). Physiotherapy is predominantly applied in palliative care units (79 %) but rarely in hospices (38 %) and outpatient palliative care teams (30 %). A structured physiotherapeutic assessment is rarely carried out even on palliative care units (26 %). Positive effects of physiotherapy are especially described for symptoms, such as edema, pain, constipation and dyspnea.

CONCLUSION

Despite its significant potential to relieve symptoms, physiotherapy is not systematically integrated into palliative care practice in Germany.

摘要

背景

姑息治疗是一种提高患有不治之症和进行性疾病患者生活质量的方法;因此,在这些情况下物理治疗可以发挥重要作用。

目的

本研究旨在探讨德国姑息和临终关怀服务中物理治疗的整合与利用情况。

方法

2013年对德国所有姑息治疗病房、专门的门诊姑息治疗团队和临终关怀机构(n = 680)进行了横断面调查。

结果

回复率为43.5%(n = 296)。物理治疗主要应用于姑息治疗病房(79%),但在临终关怀机构(38%)和门诊姑息治疗团队(30%)中很少应用。即使在姑息治疗病房,也很少进行结构化的物理治疗评估(26%)。物理治疗对水肿、疼痛、便秘和呼吸困难等症状有特别积极的效果。

结论

尽管物理治疗在缓解症状方面有巨大潜力,但在德国,它并未被系统地整合到姑息治疗实践中。

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本文引用的文献

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[A cross-sectorial analysis of physio and occupational therapy pathways after stroke].[中风后物理治疗和职业治疗途径的跨部门分析]
Gesundheitswesen. 2014 Feb;76(2):79-85. doi: 10.1055/s-0033-1337997. Epub 2013 Apr 9.
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Early palliative care for patients with metastatic non-small-cell lung cancer.转移性非小细胞肺癌患者的早期姑息治疗。
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Choosing statistical tests: part 12 of a series on evaluation of scientific publications.选择统计检验:科学出版物评估系列之十二
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Physical activity as a supportive care intervention in palliative cancer patients: a systematic review.体育活动作为姑息治疗癌症患者的支持性护理干预措施:一项系统综述。
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Preparation for palliative care: teaching about death, dying and bereavement in UK medical schools 2000-2001.姑息治疗的准备工作:2000 - 2001年英国医学院校关于死亡、临终和丧亲之痛的教学
Med Educ. 2002 Jun;36(6):561-7. doi: 10.1046/j.1365-2923.2002.01232.x.