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肌萎缩侧索硬化症(ALS)中的预先医疗照护计划:一项对肌萎缩侧索硬化症患者及其家庭照顾者进行定性纵向研究的研究方案。

Advance care planning in amyotrophic lateral sclerosis (ALS): study protocol for a qualitative longitudinal study with persons with ALS and their family carers.

机构信息

End-of-Life Care Research Group, Vrije Universiteit Brussel & Universiteit Gent, Brussel, Belgium

Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel, Brussel, Belgium.

出版信息

BMJ Open. 2022 May 12;12(5):e060451. doi: 10.1136/bmjopen-2021-060451.

DOI:10.1136/bmjopen-2021-060451
PMID:35551085
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9109106/
Abstract

INTRODUCTION

Amyotrophic lateral sclerosis (ALS) is an incurable motor neuron degenerative disease that has rapid progression and is associated with cognitive impairment. For people with ALS (pALS) and their family carers, advance care planning (ACP) is beneficial, as it can lead to feelings of control/relief and refusal of unwanted treatments. However, evidence concerning the experiences and preferences regarding ACP of pALS and their family carers, especially when their symptoms progress, is scarce. This article describes the protocol for a qualitative longitudinal study that aims to explore: (1) the experiences with ACP and the preferences for future care and treatment of pALS and their family carers and (2) how these experiences and preferences change over time.

METHODS AND ANALYSIS

A qualitative, longitudinal, multiperspective design. A total of eight to nine dyads (pALS and their family carers) will be recruited, and semistructured interviews administered every 3 months over a 9-month period. Qualitative longitudinal analysis involves content analysis via in-depth reading, followed by a two-step timeline method to describe changes in experiences and preferences within and across participants.

ETHICS AND DISSEMINATION

This protocol has been approved by the central ethical committee of the University Hospital of Brussels, and local ethical committees of the other participating hospitals (B.U.N. B1432020000128). The results will be disseminated via the research group's (endoflifecare.be) website, social media and newsletter and via presentations at national and international scientific conferences.

摘要

简介

肌萎缩侧索硬化症(ALS)是一种不可治愈的运动神经元退行性疾病,其进展迅速,并伴有认知障碍。对于肌萎缩侧索硬化症患者(pALS)及其家庭照顾者来说,预先护理计划(ACP)是有益的,因为它可以带来控制/缓解的感觉,拒绝不必要的治疗。然而,关于 pALS 及其家庭照顾者对 ACP 的体验和偏好的证据,尤其是在他们的症状进展时,却很少。本文描述了一项定性纵向研究的方案,旨在探讨:(1)pALS 及其家庭照顾者对 ACP 的体验以及对未来护理和治疗的偏好;(2)这些体验和偏好如何随时间变化。

方法和分析

定性、纵向、多视角设计。总共将招募 8 到 9 对 dyads(pALS 和他们的家庭照顾者),并在 9 个月的时间内每 3 个月进行一次半结构化访谈。定性纵向分析涉及通过深入阅读进行内容分析,然后使用两步时间线方法来描述参与者内和参与者间的体验和偏好的变化。

伦理和传播

该方案已获得布鲁塞尔大学医院的中央伦理委员会以及其他参与医院(B.U.N. B1432020000128)的地方伦理委员会的批准。结果将通过研究小组(endoflifecare.be)的网站、社交媒体和时事通讯以及在国内外科学会议上的演示进行传播。

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J Palliat Med. 2021 Jan;24(1):16-17. doi: 10.1089/jpm.2020.0540. Epub 2020 Oct 14.
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Reassessing advance care planning in the light of covid-19.鉴于新冠疫情重新评估预先护理计划
BMJ. 2020 May 18;369:m1927. doi: 10.1136/bmj.m1927.
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Top Ten Tips Palliative Care Clinicians Should Know About Amyotrophic Lateral Sclerosis.姑息治疗临床医生应了解的关于肌萎缩侧索硬化症的十大要点
J Palliat Med. 2020 Jun;23(6):842-847. doi: 10.1089/jpm.2020.0046. Epub 2020 Feb 26.
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Palliat Med. 2019 Oct;33(9):1166-1175. doi: 10.1177/0269216319864777. Epub 2019 Jul 25.
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Advance care planning in progressive neurological diseases: lessons from ALS.进展性神经疾病的预先医疗指示计划:肌萎缩性侧索硬化症的启示。
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