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患者报告的临终关怀质量结局指标:一项系统综述。

Patient reported outcome measures of quality of end-of-life care: A systematic review.

作者信息

Kearns Tara, Cornally Nicola, Molloy William

机构信息

Centre for Gerontology and Rehabilitation, University College Cork, Western Road, Cork, Ireland.

Centre for Gerontology and Rehabilitation, University College Cork, Western Road, Cork, Ireland; School of Nursing and Midwifery, University College Cork, Western Road, Cork, Ireland.

出版信息

Maturitas. 2017 Feb;96:16-25. doi: 10.1016/j.maturitas.2016.11.004. Epub 2016 Nov 11.

Abstract

End-of-life (EoL) care is increasingly used as a generic term in preference to palliative care or terminal care, particularly with reference to individuals with chronic disease, who are resident in community and long-term care (LTC) settings. This review evaluates studies based on patient reported outcome measures (PROMS) of quality of EoL care across all health-care settings. From 1041 citations, 12 studies were extracted by searches conducted in EBSCO, Scopus, Web of Science, PubMed, Cochrane, Open Grey and Google Scholar databases. At present, the evidence base for EoL care is founded on cancer care. This review highlights the paucity of studies that evaluate quality of EoL care for patients with chronic disease outside the established cancer-acute care paradigm, particularly in LTC. This review highlights the absence of any PROMs for the estimated 60% of patients in LTC with cognitive impairment. Patient-reported outcomes (PROs) are critical to understanding how EoL care services and practices affect patients' health and EoL experience. PROMs describe the quality of care from the patient's perspective and add balance to existing clinical or proxy-derived knowledge on the quality of care and services provided.

摘要

临终关怀(EoL)越来越多地被用作一个通用术语,以取代姑息治疗或终末期护理,特别是对于患有慢性病且居住在社区和长期护理(LTC)机构中的个人。本综述基于患者报告结局指标(PROMS)对所有医疗环境中的临终关怀质量研究进行评估。通过在EBSCO、Scopus、Web of Science、PubMed、Cochrane、Open Grey和谷歌学术数据库中进行检索,从1041篇文献中提取了12项研究。目前,临终关怀的证据基础建立在癌症护理之上。本综述强调,在既定的癌症-急性护理模式之外,评估慢性病患者临终关怀质量的研究很少,尤其是在长期护理机构中。本综述强调,对于长期护理机构中估计60%有认知障碍的患者,缺乏任何患者报告结局指标。患者报告结局(PROs)对于理解临终关怀服务和实践如何影响患者的健康和临终体验至关重要。患者报告结局指标从患者的角度描述了护理质量,并为现有的关于所提供护理和服务质量的临床或代理得出的知识增添了平衡。

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