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基于患者姑息治疗团队表现状态确定需求:一项观察性研究。

Identifying the Needs Based on the Patients' Performance Status for Palliative Care Team: An Observational Study.

作者信息

Sakamoto Ryo, Koyama Atsuko

机构信息

Department of Psychosomatic Medicine, Kindai University Hospital, Osakasayama, Osaka, Japan.

Centre for Palliative Care, Kindai University Hospital, Osakasayama, Osaka, Japan.

出版信息

Indian J Palliat Care. 2021 Jul-Sep;27(3):375-381. doi: 10.25259/IJPC_368_20. Epub 2021 Oct 28.

Abstract

OBJECTIVES

The study aim was to determine the association between patient performance status (PS) and the contents of a palliative care team (PCT) intervention. Identifying intervention requirements for differing PS may help to provide appropriate palliative care in under-resourced facilities.

MATERIALS AND METHODS

We collected data from medical records of inpatients ( = 496) admitted to PCT services at a centre for palliative care at Kindai University Hospital, Japan, from April 2017 to March 2019. We analysed the content of PCT activities according to each PS using Pearson's Chi-square test.

RESULTS

The following PCT activities were provided in full regardless of PS: Gastrointestinal symptoms, depression, medical staff support, food and nutrition support and oral care. The following PCT responses were associated with PS: Pain, respiratory symptoms, fatigue, insomnia, anxiety, delirium, decision-making support, family support and rehabilitation. PS3 patients tended to receive those PCT interventions associated with PS, except for anxiety and fatigue. PS4 patients received PCT interventions for respiratory symptoms, delirium and family support. Patients with good PS (0-1) tended to receive PCT interventions for anxiety.

CONCLUSION

This study demonstrated that there were different needs for different PS. The results may allow for efficient interventions even in facilities with limited resources.

摘要

目的

本研究旨在确定患者的体能状态(PS)与姑息治疗团队(PCT)干预内容之间的关联。确定不同PS的干预需求可能有助于在资源不足的医疗机构提供适当的姑息治疗。

材料与方法

我们收集了2017年4月至2019年3月期间日本近畿大学医院姑息治疗中心PCT服务收治的住院患者(n = 496)的病历数据。我们使用Pearson卡方检验根据每个PS分析了PCT活动的内容。

结果

无论PS如何,以下PCT活动均全面提供:胃肠道症状、抑郁、医务人员支持、食物和营养支持以及口腔护理。以下PCT反应与PS相关:疼痛、呼吸道症状、疲劳、失眠、焦虑、谵妄、决策支持、家庭支持和康复。PS3患者倾向于接受与PS相关的那些PCT干预,但焦虑和疲劳除外。PS4患者接受了针对呼吸道症状、谵妄和家庭支持的PCT干预。PS良好(0 - 1)的患者倾向于接受针对焦虑症的PCT干预。

结论

本研究表明不同的PS有不同的需求。这些结果即使在资源有限的医疗机构也可能实现高效干预。

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