及时识别晚期慢性心力衰竭患者的姑息治疗需求：荷兰语翻译版需求评估工具：进展性疾病-心力衰竭（NAT:PD-HF）的试点研究。
Timely recognition of palliative care needs of patients with advanced chronic heart failure: a pilot study of a Dutch translation of the Needs Assessment Tool: Progressive Disease - Heart Failure (NAT:PD-HF).
机构信息
1 Department of Research and Education, CIRO, The Netherlands.
2 Centre of Expertise for Palliative Care, Maastricht University Medical Centre (MUMC+), The Netherlands.
出版信息
Eur J Cardiovasc Nurs. 2019 Jun;18(5):375-388. doi: 10.1177/1474515119831510. Epub 2019 Feb 13.
BACKGROUND
The Needs Assessment Tool: Progressive Disease - Heart Failure (NAT:PD-HF) was developed to identify and triage palliative care needs in patients with chronic heart failure. A Dutch version is currently lacking.
AIMS
The aim of this study was to investigate the feasibility and acceptability of a Dutch NAT:PD-HF in chronic heart failure outpatients; and to gain preliminary data regarding the effect of the NAT:PD-HF on palliative care referral, symptoms, health status, care dependency, caregiver burden and advance directives.
METHODS
A mixed methods study including 23 outpatients with advanced chronic heart failure and 20 family caregivers was performed. Nurses conducted patient consultations using a Dutch translation of the NAT:PD-HF and rated acceptability. Before this visit and 4 months later, symptoms, health status, performance status, care dependency, caregiver burden and recorded advance directives were assessed. A focus group with participating nurses discussed barriers and facilitators towards palliative care needs assessment.
RESULTS
Acceptability was rated as 7 (interquartile range 6-7 points) on a 10-point scale. All patients had palliative care needs. In 48% actions were taken, including two patients referred to palliative care. Symptoms, performance status, care dependency, caregiver burden and advance directives were unchanged at 4 months, while health status deteriorated in patients completing follow-up ( n=17). Barriers towards palliative care needs assessment included feeling uncomfortable to initiate discussions and concerns about the ability to address palliative care needs.
CONCLUSIONS
The NAT:PD-HF identified palliative care needs in all participants, and triggered action to address these in half. However, training in palliative care communication skills as well as palliative care interventions should accompany the introduction of a palliative care needs assessment tool.
NETHERLANDS NATIONAL TRIAL REGISTER (NTR): 5616. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5616.
背景
需要评估工具：进展性疾病-心力衰竭（NAT：PD-HF）是为了识别和分诊慢性心力衰竭患者的姑息治疗需求而开发的。目前还没有荷兰语版本。
目的
本研究旨在调查慢性心力衰竭门诊患者使用荷兰语 NAT：PD-HF 的可行性和可接受性；并获得关于 NAT：PD-HF 对姑息治疗转介、症状、健康状况、护理依赖、照顾者负担和预先指示的初步数据。
方法
进行了一项混合方法研究，纳入了 23 名晚期慢性心力衰竭患者和 20 名家庭照顾者。护士使用 NAT：PD-HF 的荷兰语翻译进行患者咨询，并对可接受性进行评分。在此次就诊前和 4 个月后，评估症状、健康状况、表现状态、护理依赖、照顾者负担和记录的预先指示。一个由参与护士组成的焦点小组讨论了姑息治疗需求评估的障碍和促进因素。
结果
可接受性评分为 10 分制的 7 分（四分位间距 6-7 分）。所有患者都有姑息治疗需求。在 48%的患者中采取了行动，包括 2 名患者被转介到姑息治疗。在 4 个月时，症状、表现状态、护理依赖、照顾者负担和预先指示没有变化，而完成随访的患者（n=17）的健康状况恶化。姑息治疗需求评估的障碍包括不愿主动开展讨论和担心无法满足姑息治疗需求。
结论
NAT：PD-HF 确定了所有参与者的姑息治疗需求，并促使其中一半采取行动解决这些需求。然而，姑息治疗沟通技巧培训以及姑息治疗干预措施应伴随姑息治疗需求评估工具的引入。
荷兰国家试验注册（NTR）：5616。http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5616。
Zotero 插件