Skjoedt Nete, Johnsen Anna Thit, Sjøgren Per, Neergaard Mette Asbjoern, Damkier Anette, Gluud Christian, Lindschou Jane, Fayers Peter, Higginson Irene J, Strömgren Annette S, Groenvold Mogens
Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark.
Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
BMJ Support Palliat Care. 2021 Dec;11(4):444-453. doi: 10.1136/bmjspcare-2019-002043. Epub 2020 Mar 27.
Few studies have investigated the content of interventions provided in early specialised palliative care (SPC).
To characterise the content of interventions delivered in early SPC in the Danish Palliative Care Trial (DanPaCT), a multicentre trial with six participating sites.
A retrospective qualitative and quantitative study coding all new interventions initiated by the palliative teams and documented in the medical records during the 8-week study period of DanPaCT. Interventions were categorised according to (a) symptom/problem prompting the intervention, (b) type of intervention and (c) professional(s) providing the intervention.
In total, 145 patients were randomised to the SPC teams. According to the medical records, patients received a median of 3.5 (range 0-22) new interventions in the 8-week intervention-period from the palliative teams. For 24 (18%) of the patients there was no documented interventions in the medical records. The most frequent symptom/problems treated were pain, (100 interventions; 20% of interventions given) and impaired physical function (62; 13% of interventions given). The most frequent type of intervention was pharmacological (232; 42% of interventions given).
This is one of the first studies to meticulously investigate the content of interventions documented in the medical records for patients receiving early SPC. Diverse symptoms were treated with many different interventions. However, a relatively low number of interventions were documented. This may explain the lack of effect in DanPaCT but also questions whether all interventions were adequately documented TRIAL REGISTRATION NUMBER: NCT01348048.
很少有研究调查早期专科姑息治疗（SPC）所提供干预措施的内容。
在丹麦姑息治疗试验（DanPaCT）中，对早期SPC所提供干预措施的内容进行特征描述，该试验是一项有六个参与地点的多中心试验。
一项回顾性定性和定量研究，对姑息治疗团队在DanPaCT为期8周的研究期间发起并记录在病历中的所有新干预措施进行编码。干预措施根据以下方面进行分类：（a）促使采取干预措施的症状/问题，（b）干预措施的类型，以及（c）提供干预措施的专业人员。
共有145名患者被随机分配到SPC团队。根据病历记录，患者在为期8周的干预期内，从姑息治疗团队接受的新干预措施中位数为3.5（范围0 - 22）。24名（18%）患者的病历中没有记录干预措施。治疗最频繁的症状/问题是疼痛（100项干预措施；占所给予干预措施的20%）和身体功能受损（62项；占所给予干预措施的13%）。最常见的干预类型是药物治疗（232项；占所给予干预措施的42%）。
这是首批细致调查接受早期SPC患者病历中记录的干预措施内容的研究之一。多种症状通过许多不同的干预措施进行治疗。然而，记录的干预措施数量相对较少。这可能解释了DanPaCT中缺乏效果的原因，但也引发了关于所有干预措施是否都得到充分记录的疑问。试验注册号：NCT013
