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系统评价和质量指标的批判性评估,以评估最佳的姑息治疗为老年痴呆症患者。

A systematic review and critical appraisal of quality indicators to assess optimal palliative care for older people with dementia.

机构信息

1 Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK.

2 Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK.

出版信息

Palliat Med. 2019 Apr;33(4):415-429. doi: 10.1177/0269216319834227. Epub 2019 Mar 11.

DOI:10.1177/0269216319834227
PMID:30854933
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6439949/
Abstract

BACKGROUND

A challenge for commissioners and providers of end-of-life care in dementia is to translate recommendations for good or effective care into quality indicators that inform service development and evaluation.

AIM

To identify and critically evaluate quality indicators for end-of-life care in dementia.

RESULTS

We found 8657 references, after de-duplication. In all, 19 publications describing 10 new and 3 updated sets of indicators were included in this review. Ultimately, 246 individual indicators were identified as being relevant to dementia end-of-life care and mapped against EAPC guidelines.

CONCLUSIONS

We systematically derived and assessed a set of quality indicators using a robust framework that provides clear definitions of aspects of palliative care, which are dementia specific, and strengthens the theoretical underpinning of new complex interventions in end-of-life care in dementia.

摘要

背景

痴呆症终末期护理的管理者和提供者所面临的一个挑战,是将优质或有效护理的建议转化为质量指标,从而为服务的发展和评估提供信息。

目的

确定并批判性评估痴呆症终末期护理的质量指标。

结果

去重后,我们共检索到 8657 篇参考文献。本综述共纳入了 19 篇文献,描述了 10 组新的和 3 组更新的指标集。最终,共确定了 246 个与痴呆症终末期护理相关的个体指标,并根据 EAPC 指南进行了映射。

结论

我们使用一个强大的框架系统地推导出和评估了一组质量指标,该框架对姑息治疗的各个方面提供了明确的定义,这些方面是痴呆症特有的,并且增强了新的痴呆症终末期护理复杂干预措施的理论基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ebe/6439949/cc62f7027da3/10.1177_0269216319834227-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ebe/6439949/cc62f7027da3/10.1177_0269216319834227-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ebe/6439949/cc62f7027da3/10.1177_0269216319834227-fig1.jpg

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本文引用的文献

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Am J Psychiatry. 2017 May 1;174(5):493-498. doi: 10.1176/appi.ajp.2017.17401.
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Palliative Care Quality Indicators for Patients with End-Stage Liver Disease Due to Cirrhosis.肝硬化所致终末期肝病患者的姑息治疗质量指标
Dig Dis Sci. 2017 Jan;62(1):84-92. doi: 10.1007/s10620-016-4339-3. Epub 2016 Nov 1.
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End of life care--why those with dementia have different needs.临终关怀——痴呆症患者为何有不同需求。
Models of care for people with dementia approaching end of life: A rapid review.
临终前痴呆症患者的护理模式:快速综述。
Palliat Med. 2023 Jul;37(7):915-930. doi: 10.1177/02692163231171181. Epub 2023 May 7.
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Earlier initiation of palliative care in the disease trajectory of people living with dementia: a scoping review protocol. 早期启动姑息治疗在痴呆患者疾病进程中的研究:范围综述方案。
BMJ Open. 2021 Jun 21;11(6):e044502. doi: 10.1136/bmjopen-2020-044502.
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Lessons from the COVID-19 pandemic for improving outpatient neuropalliative care: A qualitative study of patient and caregiver perspectives.从 COVID-19 大流行中吸取教训,改善门诊神经姑息治疗:一项基于患者和照护者观点的定性研究。
Palliat Med. 2021 Jul;35(7):1258-1266. doi: 10.1177/02692163211017383. Epub 2021 May 18.
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Understanding Interactions Between Caregivers and Care Recipients in Person-Centered Dementia Care: A Rapid Review.理解以患者为中心的痴呆症护理中护理人员与护理接受者之间的相互作用:快速综述。
Clin Interv Aging. 2020 Sep 14;15:1637-1647. doi: 10.2147/CIA.S255454. eCollection 2020.
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Systematic Quality Monitoring For Specialized Palliative Care Services: Development of a Minimal Set of Quality Indicators for Palliative Care Study (QPAC).专科姑息治疗服务的系统质量监测:姑息治疗研究(QPAC)最小质量指标集的制定
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