School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.
Department of Basic Sciences, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.
BMJ Open. 2020 Feb 4;10(2):e034413. doi: 10.1136/bmjopen-2019-034413.
The benefits of palliative care rely on how healthcare professionals assess patients' needs in the initial encounter/s; crucial to the design of a personalised therapeutic plan. However, there is currently no evidence-based guideline to perform this needs assessment. We aim to design and evaluate a proactive and systematic method for the needs assessment using quality guidelines for developing complex interventions. This will involve patients, their relatives and healthcare professionals in all phases of the study and its communication to offer clinical practice a reliable approach to address the palliative needs of patients.
To design and assess the feasibility of an evidence-based, proactive and systematic Multidimensional needs Assessment in Palliative care (MAP) as a semistructured clinical interview guide for initial palliative care encounter/s in patients with advanced cancer. This is a two-phase multisite project conducted over 36 months between May 2019 and May 2022. Phase I includes a systematic review, discussions with stakeholders and Delphi consensus. The evidence gathered from phase I will be the basis for the initial versions of the MAP, then submitted to Delphi consensus to develop a preliminary guide of the MAP for the training of clinicians in the feasibility phase. Phase II is a mixed-methods multicenter feasibility study that will assess the MAP's acceptability, participation, practicality, adaptation and implementation. A nested qualitative study will purposively sample a subset of participants to add preliminary clues about the benefits and barriers of the MAP. The evidence gathered from phase II will build a MAP user guide and educational programme for use in clinical practice.
Ethical approval for this study has been granted by the university research ethics committee where the study will be carried out (approval reference MED-2018-10). Dissemination will be informed by the results obtained and communication will occur throughout.
姑息治疗的益处取决于医疗保健专业人员在初次接触/时如何评估患者的需求；这对于制定个性化治疗计划至关重要。然而，目前没有基于证据的指南来进行这种需求评估。我们旨在使用开发复杂干预措施的质量指南来设计和评估一种主动的、系统的需求评估方法。这将涉及患者、他们的亲属和医疗保健专业人员在研究的所有阶段及其沟通，为临床实践提供一种可靠的方法来满足患者的姑息治疗需求。
设计并评估一种基于证据的、主动的和系统的姑息治疗多维需求评估（MAP）的可行性，作为一种半结构化的临床访谈指南，用于晚期癌症患者的初始姑息治疗接触/。这是一个为期 36 个月的两阶段多地点项目，于 2019 年 5 月至 2022 年 5 月进行。第 I 阶段包括系统评价、与利益相关者的讨论和德尔菲共识。第 I 阶段收集的证据将是 MAP 的初始版本的基础，然后提交给德尔菲共识，以制定 MAP 的初步指南，用于在可行性阶段培训临床医生。第 II 阶段是一项混合方法多中心可行性研究，将评估 MAP 的可接受性、参与性、实用性、适应性和实施情况。一项嵌套的定性研究将有目的地选择一部分参与者，以初步了解 MAP 的益处和障碍。第 II 阶段收集的证据将构建一个 MAP 用户指南和教育计划，用于临床实践。
该研究的伦理批准已获得将进行研究的大学研究伦理委员会的批准（批准参考号 MED-2018-10）。传播将根据获得的结果进行，并将在整个过程中进行沟通。
