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全科医学中的临终关怀:基于诊所的数据收集。

End-of-life care in general practice: clinic-based data collection.

机构信息

Medical School, The University of Western Australia, Perth, Western Australia, Australia

School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia.

出版信息

BMJ Support Palliat Care. 2022 May;12(e1):e155-e163. doi: 10.1136/bmjspcare-2019-002006. Epub 2020 Feb 17.

Abstract

BACKGROUND

There are no processes that routinely assess end-of-life care in Australian general practice. This study aimed to develop a data collection process which could collect observational data on end-of-life care from Australian general practitioners (GPs) via a questionnaire and clinical data from general practice software.

METHODS

The data collection process was developed based on a modified Delphi study, then pilot tested with GPs through online surveys across three Australian states and data extraction from general practice software, and finally evaluated through participant interviews.

RESULTS

The developed data collection process consisted of three questionnaires: Basic Practice Descriptors (32 items), Clinical Data Query (32 items) and GP-completed Questionnaire (21 items). Data extraction from general practice software was performed for 97 decedents of 10 GPs and gathered data on prescriptions, investigations and referral patterns. Reports on care of 272 decedents were provided by 63 GPs. The GP-completed Questionnaire achieved a satisfactory level of validity and reliability. Our interviews with 23 participating GPs demonstrated the feasibility and acceptability of this data collection process in Australian general practice.

CONCLUSIONS

The data collection process developed and tested in this study is feasible and acceptable for Australian GPs, and comprehensively covers the major components of end-of-life care. Future studies could develop an automated data extraction tool to reduce the time and recall burden for GPs. These findings will help build a nationwide integrated information network for primary end-of-life care in Australia.

摘要

背景

澳大利亚的一般实践中没有常规评估临终关怀的流程。本研究旨在开发一种数据收集流程,通过问卷和一般实践软件中的临床数据,从澳大利亚的全科医生(GP)那里收集关于临终关怀的观察数据。

方法

该数据收集流程是基于改良的 Delphi 研究制定的,然后通过在澳大利亚三个州的在线调查和从一般实践软件中提取数据对全科医生进行了试点测试,最后通过参与者访谈进行了评估。

结果

所开发的数据收集流程包括三个问卷:基本实践描述符(32 项)、临床数据查询(32 项)和 GP 完成问卷(21 项)。从 10 名全科医生的 97 名死者中提取了一般实践软件的数据,并收集了处方、检查和转诊模式的数据。63 名全科医生提供了 272 名死者的护理报告。GP 完成问卷达到了令人满意的有效性和可靠性水平。我们对 23 名参与的全科医生进行的访谈表明,该数据收集流程在澳大利亚的一般实践中是可行和可接受的。

结论

本研究中开发和测试的数据收集流程对澳大利亚的全科医生来说是可行和可接受的,全面涵盖了临终关怀的主要组成部分。未来的研究可以开发一种自动数据提取工具,以减少全科医生的时间和回忆负担。这些发现将有助于在澳大利亚建立一个全国性的初级临终关怀综合信息网络。

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