1 Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
2 Division of Health Research, International Observatory on End of Life Care, Lancaster University, Lancaster, UK.
Palliat Med. 2018 Jun;32(6):1103-1113. doi: 10.1177/0269216318756812. Epub 2018 Feb 5.
: Although examining perspectives of patients on integrated palliative care organisation is essential, available literature is largely based on administrative data or healthcare professionals’ perspectives.
: (1) Providing insight into the composition and quality of care networks of patients receiving palliative care and (2) describing perceived integration between healthcare professionals within these networks and its association with overall satisfaction.
: Cross-sectional explorative design.
SETTING/PARTICIPANTS:: We recruited 157 patients (62% cancer, 25% chronic obstructive pulmonary disease, 13% chronic heart failure, mean age 68 years, 55% female) from 23 integrated palliative care initiatives in Belgium, Germany, the United Kingdom, Hungary and the Netherlands.
: About 33% reported contact with a palliative care specialist and 48% with a palliative care nurse. Relationships with palliative care specialists were rated significantly higher than other physicians ( < 0.001). Compared to patients with cancer, patients with chronic obstructive pulmonary disease (odds ratio = 0.16, confidence interval (0.04; 0.57)) and chronic heart failure (odds ratio = 0.11, confidence interval (0.01; 0.93)) had significantly lower odds of reporting contact with palliative care specialists and patients with chronic obstructive pulmonary disease (odds ratio = 0.23, confidence interval (0.08; 0.71)) had significantly lower odds of reporting contact with palliative care nurses. Perceptions of main responsible healthcare professionals or caregivers in patient’s care networks varied across countries. Perceived integration was significantly associated with overall satisfaction.
: Palliative care professionals are not always present or recognised as such in patients’ care networks. Expert palliative care involvement needs to be explicated especially for non-cancer patients. One healthcare professional should support patients in understanding and navigating their palliative care network. Patients seem satisfied with care provision as long as continuity of care is provided.
尽管了解患者对综合姑息治疗组织的看法至关重要，但现有文献主要基于行政数据或医疗保健专业人员的观点。
（1）深入了解接受姑息治疗的患者的护理网络的组成和质量；（2）描述这些网络中医疗保健专业人员之间的感知整合及其与整体满意度的关联。
横断面探索性设计。
设置/参与者：我们从比利时、德国、英国、匈牙利和荷兰的 23 个综合姑息治疗计划中招募了 157 名患者（62%为癌症患者，25%为慢性阻塞性肺疾病患者，13%为慢性心力衰竭患者，平均年龄 68 岁，55%为女性）。
约 33%的患者报告与姑息治疗专家有过接触，48%的患者与姑息治疗护士有过接触。患者与姑息治疗专家的关系评分明显高于其他医生（<0.001）。与癌症患者相比，慢性阻塞性肺疾病（比值比=0.16，置信区间（0.04；0.57））和慢性心力衰竭（比值比=0.11，置信区间（0.01；0.93））患者报告与姑息治疗专家接触的可能性明显较低，慢性阻塞性肺疾病患者（比值比=0.23，置信区间（0.08；0.71））报告与姑息治疗护士接触的可能性明显较低。患者护理网络中主要负责的医疗保健专业人员或护理人员的看法因国家而异。感知整合与整体满意度显著相关。
姑息治疗专业人员在患者的护理网络中并不总是存在或被视为如此。需要特别为非癌症患者阐明专家姑息治疗的参与。应让一名医疗保健专业人员支持患者理解和管理他们的姑息治疗网络。只要提供连续性护理，患者似乎对护理服务感到满意。
