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验证舒缓治疗中需求紧急度响应(RUN-PC)分诊工具。

Validation of the responding to urgency of need in palliative care (RUN-PC) triage tool.

机构信息

Palliative Nexus Research Group, University of Melbourne and St Vincent's Hospital Melbourne, VIC, Australia.

Department of Palliative Care, St Vincent's Hospital Melbourne, VIC, Australia.

出版信息

Palliat Med. 2021 Apr;35(4):759-767. doi: 10.1177/0269216320986730. Epub 2021 Jan 21.

Abstract

BACKGROUND

The Responding to Urgency of Need in Palliative Care (RUN-PC) Triage Tool is a novel, evidence-based tool by which specialist palliative care services can manage waiting lists and workflow by prioritising access to care for those patients with the most pressing needs in an equitable, efficient and transparent manner.

AIM

This study aimed to establish the intra- and inter-rater reliability, and convergent validity of the RUN-PC Triage Tool and generate recommended response times.

DESIGN

An online survey of palliative care intake officers applying the RUN-PC Triage Tool to a series of 49 real clinical vignettes was assessed against a reference standard: a postal survey of expert palliative care clinicians ranking the same vignettes in order of urgency.

SETTING/PARTICIPANTS: Intake officers ( = 28) with a minimum of 2 years palliative care experience and expert clinicians ( = 32) with a minimum of 10 years palliative care experience were recruited from inpatient, hospital consultation and community palliative care services across metropolitan and regional Victoria, Australia.

RESULTS

The RUN-PC Triage Tool has good intra- and inter-rater reliability in inpatient, hospital consultation and community palliative care settings (Intraclass Correlation Coefficients ranged from 0.61 to 0.74), and moderate to good correlation to expert opinion used as a reference standard (Kendall's Tau rank correlation coefficients ranged from 0.68 to 0.83).

CONCLUSION

The RUN-PC Triage Tool appears to be a reliable and valid tool for the prioritisation of patients referred to specialist inpatient, hospital consultation and community palliative care services.

摘要

背景

《缓和医疗需求响应工具(RUN-PC)》是一种新的基于证据的工具,通过该工具,专科缓和医疗服务可以通过公平、高效和透明的方式,优先考虑最需要的患者获得护理,从而管理等候名单和工作流程。

目的

本研究旨在评估 RUN-PC 分诊工具的组内和组间可靠性和收敛效度,并生成推荐的响应时间。

设计

对具有至少 2 年缓和医疗经验的缓和医疗入院官员进行在线调查,要求他们使用 RUN-PC 分诊工具对 49 个真实临床病例进行分类,并将其与参考标准(对同一病例进行紧急程度排序的专家缓和医疗临床医生的邮寄调查)进行对比。

设置/参与者:从澳大利亚维多利亚州大都市区和地区的住院、医院咨询和社区缓和医疗服务中招募了具有至少 2 年缓和医疗经验的入院官员( = 28)和具有至少 10 年缓和医疗经验的专家临床医生( = 32)。

结果

RUN-PC 分诊工具在住院、医院咨询和社区缓和医疗环境中具有良好的组内和组间可靠性(组内相关系数范围为 0.61 至 0.74),与作为参考标准的专家意见具有中度至良好的相关性(Kendall's Tau 等级相关系数范围为 0.68 至 0.83)。

结论

RUN-PC 分诊工具似乎是一种可靠且有效的工具,可用于对转介至专科住院、医院咨询和社区缓和医疗服务的患者进行优先排序。

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