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评估囊性纤维化患者、照护者和临床医生对姑息治疗的实践、信念和态度:内容分析的结果。

Assessing Practices, Beliefs, and Attitudes about Palliative Care among People with Cystic Fibrosis, Their Caregivers, and Clinicians: Results of a Content Analysis.

机构信息

Northwell Health, Manhasset, New York, USA.

Molloy College, Rockville Centre, New York, USA.

出版信息

J Palliat Med. 2021 Nov;24(11):1650-1656. doi: 10.1089/jpm.2020.0725. Epub 2021 Apr 20.

DOI:10.1089/jpm.2020.0725
PMID:33885355
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8856014/
Abstract

Individuals with cystic fibrosis (CF) experience symptoms affecting quality of life and may benefit from palliative care (PC). To present results of content analysis from open-ended survey questions assessing knowledge and experiences with PC among CF stakeholders. Online surveys were sent to CF stakeholders through CF-specific listservs predominantly in the United States. Responses to five open-ended questions about CF PC-delivery, health care provider training, and lung transplant-underwent content analysis. Responses were coded using NVivo12 Software™. Forty-eight CF adults, 59 caregivers, and 229 providers responded to the open-ended survey questions. Analysis showed 5 primary categories related to CF PC: (1) stakeholder perceptions of PC for CF, (2) delivering PC to people with CF, (3) conversations about PC for CF, (4) perceptions that PC services are underutilized for people with CF, and (5) beliefs that PC services are critical for people with CF considering or pursuing lung transplant. Analysis showed variation among and within groups in defining PC for CF, when, and how to deliver it. Many respondents felt PC was underutilized in CF. Most saw PC as particularly important when considering lung transplant, managing anxiety around transplant, and for goals of care discussions. Some believed PC and lung transplant were mutually exclusive. Respondents felt PC is underutilized for CF, and that people with CF may miss out on the benefits of PC. Among stakeholders, respondents felt people with CF would benefit from access to primary and secondary PC services.

摘要

个体患有囊性纤维化 (CF) 会出现影响生活质量的症状,可能受益于姑息治疗 (PC)。本研究旨在展示对 CF 利益相关者 PC 知识和经验的开放式调查问题的内容分析结果。通过 CF 特定的邮件列表,主要在美国向 CF 利益相关者在线发送了调查。对关于 CF PC 交付、医疗保健提供者培训和肺移植的五个开放式问题的回答进行了内容分析。使用 NVivo12 软件对回答进行编码。48 名 CF 成年人、59 名照顾者和 229 名提供者对开放式调查问题做出了回应。分析显示,CF PC 有 5 个主要类别:(1)CF PC 的利益相关者看法,(2)为 CF 患者提供 PC,(3)CF PC 的对话,(4)认为 CF 患者的 PC 服务利用率低,以及(5)认为对于考虑或寻求肺移植的 CF 患者,PC 服务至关重要。分析显示,在 CF 中定义 PC、何时以及如何提供 PC 方面,不同群体和群体内部存在差异。许多受访者认为 CF 的 PC 利用率较低。大多数人认为 PC 在考虑肺移植、管理移植相关焦虑和进行护理目标讨论时尤为重要。有些人认为 PC 和肺移植是相互排斥的。受访者认为 CF 患者的 PC 利用率较低,CF 患者可能会错过 PC 的好处。在利益相关者中,受访者认为 CF 患者将受益于获得初级和二级 PC 服务。

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本文引用的文献

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Models of Palliative Care Delivery for Individuals with Cystic Fibrosis: Cystic Fibrosis Foundation Evidence-Informed Consensus Guidelines.囊性纤维化患者姑息治疗提供模式:囊性纤维化基金会循证共识指南。
J Palliat Med. 2021 Jan;24(1):18-30. doi: 10.1089/jpm.2020.0311. Epub 2020 Sep 16.
2
Palliative care skills in CF: Perspectives of adults with CF, caregivers, and CF care team members.CF 患者的姑息治疗技能:CF 患者、照护者和 CF 护理团队成员的观点。
Pediatr Pulmonol. 2020 Aug;55(8):2017-2024. doi: 10.1002/ppul.24806. Epub 2020 May 8.
3
Palliative Care Needs of Individuals with Cystic Fibrosis: Perspectives of Multiple Stakeholders.囊性纤维化患者的姑息治疗需求:多方利益相关者的观点。
J Palliat Med. 2020 Jul;23(7):957-963. doi: 10.1089/jpm.2019.0464. Epub 2020 Feb 5.
4
"I'd Have to Basically Be on My Deathbed": Heart Failure Patients' Perceptions of and Preferences for Palliative Care.“我基本上得躺在临终病床上了”:心力衰竭患者对姑息治疗的看法和偏好。
J Palliat Med. 2020 Jul;23(7):915-921. doi: 10.1089/jpm.2019.0451. Epub 2020 Jan 9.
5
Prevalence of unmet palliative care needs in adults with cystic fibrosis.成年囊性纤维化患者未满足的姑息治疗需求的患病率。
J Cyst Fibros. 2020 May;19(3):394-401. doi: 10.1016/j.jcf.2019.11.010. Epub 2019 Dec 18.
6
Comparing Specialty and Primary Palliative Care Interventions: Analysis of a Systematic Review.比较专科和初级姑息治疗干预措施:系统评价分析。
J Palliat Med. 2020 Mar;23(3):389-396. doi: 10.1089/jpm.2019.0349. Epub 2019 Oct 23.
7
Outcomes of Embedded Palliative Care Outpatients Initial Consults on Timing of Palliative Care Access, Symptoms, and End-of-Life Quality Care Indicators among Advanced Nonsmall Cell Lung Cancer Patients.晚期非小细胞肺癌患者姑息治疗门诊初始咨询在姑息治疗介入时机、症状及临终优质护理指标方面的结果
J Palliat Med. 2018 Aug 1. doi: 10.1089/jpm.2018.0134.
8
Models of non-hospice palliative care: a review.非临终关怀姑息治疗模式:综述
Ann Palliat Med. 2019 Feb;8(Suppl 1):S15-S21. doi: 10.21037/apm.2018.03.11. Epub 2018 Apr 25.
9
Defining palliative care in cystic fibrosis: A Delphi study.定义囊性纤维化中的姑息治疗:一项德尔菲研究。
J Cyst Fibros. 2018 May;17(3):416-421. doi: 10.1016/j.jcf.2017.10.011. Epub 2017 Oct 31.
10
Palliative Care in Heart Failure: Rationale, Evidence, and Future Priorities.心力衰竭的姑息治疗:基本原理、证据及未来重点
J Am Coll Cardiol. 2017 Oct 10;70(15):1919-1930. doi: 10.1016/j.jacc.2017.08.036.