Servicio de Medicina Interna, Hospital Royo Villanova, Zaragoza, Spain.
Servicio de Medicina Interna, Hospital Clínico Universitario, Valladolid, Spain.
Rev Clin Esp (Barc). 2021 Jan;221(1):33-44. doi: 10.1016/j.rceng.2020.04.009. Epub 2020 Nov 24.
To develop consensus recommendations about good clinical practice rules for caring end-of-life patients.
A steering committee of 12 Spanish and Portuguese experts proposed 37 recommendations. A two rounds Delphi method was performed, with participation of 105 panelists including internists, other clinicians, nurses, patients, lawyers, bioethicians, health managers, politicians and journalists. We sent a questionnaire with 5 Likert-type answers for each recommendation. Strong consensus was defined when >95% answers were completely agree or >90% were agree or completely agree; and weak consensus when >90% answers were completely agree or >80% were agree or completely agree.
The panel addressed 7 specific areas for 37 recommendations spanning: identification of patients; knowledge of the disease, values and preferences of the patient; information; patient's needs; support and care; palliative sedation, and after death care.
The panel formulated and provided the rationale for recommendations on good clinical practice rules for caring end-of-life patients.
制定临终关怀患者良好临床实践规则的共识建议。
由 12 名西班牙和葡萄牙专家组成的指导委员会提出了 37 条建议。采用两轮德尔菲法，共有包括内科医生、其他临床医生、护士、患者、律师、生物伦理学家、卫生管理人员、政治家和记者在内的 105 名小组成员参与。我们发送了一份问卷，其中包含对每个建议的 5 个李克特量表答案。当>95%的答案完全同意或>90%的答案同意或完全同意时，定义为强共识；当>90%的答案完全同意或>80%的答案同意或完全同意时，定义为弱共识。
该小组讨论了 7 个特定领域的 37 条建议，涵盖：患者识别；疾病知识、患者的价值观和偏好；信息；患者的需求；支持和护理；缓和性镇静，以及死后护理。
该小组制定并提供了临终关怀患者良好临床实践规则建议的依据。
