1 Oregon Health and Science University School of Nursing , Portland, Oregon.
2 Department of Multnomah County Health, Portland, Oregon.
J Palliat Med. 2018 Aug;21(8):1114-1121. doi: 10.1089/jpm.2017.0666. Epub 2018 May 24.
Many older adults live with serious illness for years before their death. Nurse-led primary palliative care could improve their quality of life and ability to stay in their community.
To assess feasibility and acceptability of a nurse-led Transitional Palliative Care (TPC) program for older adults with serious illness.
The study was a pilot trial of the TPC program in which registered nurses assisted patients with symptom management, communication with care providers, and advance care planning. Forty-one older adults with chronic conditions were enrolled in TPC or standard care groups. Feasibility was assessed through enrollment and attrition rates and degree of intervention execution. Acceptability was assessed through surveys and exit interviews with participants and intervention nurses.
Enrollment rate for those approached was 68%, and completion rate for those enrolled was 71%. The TPC group found the intervention acceptable and helpful and was more satisfied with care received than the control group. However, one-third of participants perceived that TPC was more than they needed, despite the number of symptoms they experienced and the burdensomeness of their symptoms. More than half of the participants had little to no difficulty participating in daily activities.
This study demonstrated that the nurse-led TPC program is feasible, acceptable, and perceived as helpful. However, further refinement is needed in selection criteria to identify the population who would most benefit from primary palliative care before future test of the efficacy of this intervention.
许多老年人在去世前会患有严重疾病多年。护士主导的初级姑息治疗可以提高他们的生活质量和留在社区的能力。
评估护士主导的过渡性姑息治疗（TPC）方案在患有严重疾病的老年人中的可行性和可接受性。
该研究是 TPC 方案的一项试点试验，注册护士在该方案中协助患者进行症状管理、与护理提供者沟通和预先护理计划。41 名患有慢性病的老年人被纳入 TPC 或标准护理组。通过入组和脱落率以及干预执行程度评估可行性。通过参与者和干预护士的调查和退出访谈评估可接受性。
被接触者的入组率为 68%，入组者的完成率为 71%。TPC 组认为干预措施是可接受和有帮助的，并且比对照组对所接受的护理更满意。然而，尽管参与者经历的症状数量和症状的负担程度不同，仍有三分之一的参与者认为 TPC 超出了他们的需求。超过一半的参与者在参与日常活动方面几乎没有困难。
本研究表明，护士主导的 TPC 方案是可行的、可接受的，并且被认为是有帮助的。然而，在未来测试这种干预措施的疗效之前，需要进一步改进选择标准，以确定最需要初级姑息治疗的人群。
