University of California San Diego, Doris A. Howell Palliative Care Teams, La Jolla, California, USA.
University of California San Diego, Doris A. Howell Palliative Care Teams, La Jolla, California, USA.
J Pain Symptom Manage. 2021 Oct;62(4):813-819. doi: 10.1016/j.jpainsymman.2021.02.020. Epub 2021 Feb 22.
Specialist palliative care social work (PCSW) across a four-team palliative care (PC) service in the inpatient setting at a tertiary academic medical center.
to describe the population of patients seen by inpatient PCSW, quantification of the involvement of PCSW in PC consultations, as well as comparisons of patient characteristics for those seen by PCSW and the overall population seen by the PC team.
Retrospective chart review of patients admitted to a tertiary academic medical center between January, 1 2015 and October 31, 2019 who received a PC consult.
Over the study period, PCSW saw 2,381 out of the 4907 patients seen by the palliative care teams for a PCSW penetration rate of 52% with an 83% increase in the percent of consults seen by PCSW and a 133% increase in PCSW staffing over the study period. Compared to all PC consults, when PCSW was involved in the case, the LOS is longer (average 15.6d vs. 14.4d; P = 0.0062); goals of care are more likely to be addressed (90.7% vs. 87.4%, P = 0.004); dyspnea was more likely to improve (43.3% vs. 31.9%, P = 0.018) and pain was less likely to improve (28.2% vs. 49.4%, P < 0.001).
Involvement of PCSW increased dramatically over the study period. Compared to the rest of the PC team, when PCSW was involved, length of stay was longer, whole-person care components were more likely to be addressed, dyspnea was significantly improved, and pain was significantly worse when compared to those consults not seen by PCSW. Other symptoms such as nausea and anxiety as well as discharge characteristics such as death or hospice discharge were not significantly different with involvement of PCSW.
在一家三级学术医疗中心的住院环境中，四个姑息治疗（PC）团队中的专业姑息治疗社会工作者（PCSW）。
描述 PCSW 所服务的患者人群，量化 PCSW 在 PC 咨询中的参与程度，以及比较 PCSW 服务的患者特征与 PC 团队总体服务的患者特征。
回顾性分析 2015 年 1 月 1 日至 2019 年 10 月 31 日期间在三级学术医疗中心住院并接受 PC 咨询的患者的病历。
在研究期间，PCSW 对姑息治疗团队服务的 4907 名患者中的 2381 名患者进行了评估，PCSW 渗透率为 52%，PCSW 参与的咨询比例增加了 83%，PCSW 人员配备增加了 133%。与所有 PC 咨询相比，当 PCSW 参与病例时，LOS 更长（平均 15.6 天 vs. 14.4 天；P=0.0062）；更有可能解决治疗目标（90.7% vs. 87.4%，P=0.004）；呼吸困难更有可能改善（43.3% vs. 31.9%，P=0.018），疼痛改善的可能性较小（28.2% vs. 49.4%，P<0.001）。
在研究期间，PCSW 的参与率大幅增加。与 PC 团队的其他成员相比，当 PCSW 参与时，住院时间更长，更有可能解决全人护理的各个方面，呼吸困难显著改善，疼痛显著恶化，与 PCSW 未参与的咨询相比。涉及 PCSW 时，恶心和焦虑等其他症状以及死亡或临终关怀出院等出院特征没有显著差异。
