Global HOPE Botswana (K.C.), Gaborone, Botswana; Baylor College of Medicine (J.C., J.H., M.H.), Houston, Texas, USA; Texas Children's Hospital (J.C., J.H.), Houston, Texas, USA; Global HOPE Malawi (R.B, M.B.), Lilongwe, Malawi; Global HOPE Uganda (A.N., D.B., I.N.), Kampala, Uganda; Princess Marina Hospital (B.G., G.M.M.), Gaborone, Botswana.
J Pain Symptom Manage. 2022 Jun;63(6):962-970. doi: 10.1016/j.jpainsymman.2022.02.021. Epub 2022 Feb 21.
In sub-Saharan Africa, there is no standardized approach to pediatric palliative care assessment. Because of this, there is a critical demand for evidence-based assessment tools that identify the specialized needs of children and their families requiring palliative care in developing countries.
To develop a standardized approach to pediatric palliative care (PPC) assessment that includes an individualized plan of care for use in sub-Saharan Africa.
A Delphi method approach used five rounds to explore core elements that define the essential assessment attributes mandatory for providing excellence in PPC. Using the Delphi method, the consensus from 11 PPC experts was obtained during four Delphi rounds regarding the most important questions to include in a PPC assessment tool and plan of care. During the final Delphi round 5, the expert consensus was confirmed in a separate group of 36 childhood cancer/palliative care clinical providers.
Five core elements were developed as the foundation for a PPC assessment. A symptom assessment tool was developed that includes 15 symptoms that PPC experts agreed occurred more than 65% of the time in their patients.
The Delphi method was an effective tool to develop a consensus on a PPC assessment tool to use with children and their families in sub-Saharan Africa. This standardized approach will enable the collection of data to drive outcomes and research.
在撒哈拉以南非洲,儿科姑息治疗评估没有标准化的方法。因此,非常需要有循证评估工具来识别发展中国家需要姑息治疗的儿童及其家庭的特殊需求。
制定一种标准化的儿科姑息治疗(PPC)评估方法,其中包括针对撒哈拉以南非洲的个性化护理计划。
采用德尔菲法(Delphi method),通过五轮探索来确定定义提供卓越 PPC 所必需的基本评估属性的核心要素。通过德尔菲法,在四轮德尔菲回合中,11 名 PPC 专家就姑息治疗评估工具和护理计划中应包括的最重要问题达成了共识。在第五轮德尔菲回合中,对 36 名儿童癌症/姑息治疗临床提供者进行了确认。
确定了五个核心要素作为 PPC 评估的基础。制定了一个症状评估工具,其中包括姑息治疗专家一致认为在他们的患者中出现超过 65%的 15 种症状。
德尔菲法是一种制定儿科姑息治疗评估工具的有效工具,可用于撒哈拉以南非洲的儿童及其家庭。这种标准化的方法将能够收集数据以推动结果和研究。