养老院工作人员对姑息治疗原则的认同：五项欧洲国家护士和护理助理参与的 PACE 横断面研究。

Agreement of Nursing Home Staff With Palliative Care Principles: A PACE Cross-sectional Study Among Nurses and Care Assistants in Five European Countries.

机构信息

Department of Family Medicine & Chronic Care, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium.

出版信息

J Pain Symptom Manage. 2019 Nov;58(5):824-834. doi: 10.1016/j.jpainsymman.2019.06.015. Epub 2019 Jul 31.

DOI:10.1016/j.jpainsymman.2019.06.015

PMID:31376522

Abstract

CONTEXT

To provide high-quality palliative care to nursing home residents, staff need to understand the basic principles of palliative care.

OBJECTIVES

To evaluate the extent of agreement with the basic principles of palliative care of nurses and care assistants working in nursing homes in five European countries and to identify correlates.

METHODS

This is a cross-sectional study in 214 homes in Belgium, England, Italy, the Netherlands, and Poland. Agreement with basic principles of palliative care was measured with the Rotterdam MOVE2PC. We calculated percentages and odds ratios of agreement and an overall score between 0 (no agreement) and 5 (total agreement).

RESULTS

Most staff in all countries agreed that palliative care involves more than pain treatment (58% Poland to 82% Belgium) and includes spiritual care (62% Italy to 76% Belgium) and care for family or relatives (56% Italy to 92% Belgium). Between 51% (the Netherlands) and 64% (Belgium) correctly disagreed that palliative care should start in the last week of life and 24% (Belgium) to 53% (Poland) agreed that palliative care and intensive life-prolonging treatment can be combined. The overall agreement score ranged between 1.82 (Italy) and 3.36 (England). Older staff (0.26; 95% confidence interval [CI]: 0.09-0.43, P = 0.003), nurses (0.59; 95% CI: 0.43-0.75, P < 0.001), and staff who had undertaken palliative care training scored higher (0.21; 95% CI: 0.08-0.34, P = 0.002).

CONCLUSIONS

The level of agreement of nursing home staff with basic principles of palliative care was only moderate and differed between countries. Efforts to improve the understanding of basic palliative care are needed.

摘要

背景

为了向养老院居民提供高质量的姑息治疗，工作人员需要了解姑息治疗的基本原则。

目的

评估在比利时、英国、意大利、荷兰和波兰的五个欧洲国家的养老院护士和护理助理对姑息治疗基本原则的认同程度，并确定相关因素。

方法

这是一项在 214 家养老院进行的横断面研究。使用 Rotterdam MOVE2PC 评估对姑息治疗基本原则的认同程度。我们计算了每个国家的百分比和优势比，并得出 0（完全不同意）到 5（完全同意）之间的总分。

结果

所有国家的大多数工作人员都认为姑息治疗不仅仅涉及疼痛治疗（波兰为 58%，比利时为 82%），还包括精神关怀（意大利为 62%，比利时为 76%）和对家庭或亲属的关怀（意大利为 56%，比利时为 92%）。有 51%（荷兰）至 64%（比利时）的人不同意姑息治疗应在生命的最后一周开始，有 24%（比利时）至 53%（波兰）的人同意姑息治疗和强化延长生命的治疗可以结合使用。总体认同评分在 1.82（意大利）至 3.36（英格兰）之间。年龄较大的工作人员（0.26；95%置信区间[CI]：0.09-0.43，P=0.003）、护士（0.59；95% CI：0.43-0.75，P<0.001）和接受过姑息治疗培训的工作人员得分更高（0.21；95% CI：0.08-0.34，P=0.002）。