晚期癌症急诊护理中的姑息治疗分诊系统：开发与初步验证

The palliative care triage system in advanced cancer emergency care: development and initial validation.

作者信息

Paiva Carlos Eduardo, Seriaco Fabíola de Lourdes Gonçalves de Freitas, de Oliveira Marco Antônio, Nascimento Maria Salete de Angelis, Paiva Bianca Sakamoto Ribeiro

机构信息

Department of Clinical Oncology, Hospital de Câncer de Barretos, Barretos, Brazil

Palliative Care and Quality of Life Research Group (GPQual), Barretos Cancer Hospital, Barretos, SP, Brazil.

出版信息

BMJ Support Palliat Care. 2022 Aug 30. doi: 10.1136/spcare-2022-003713.

DOI:10.1136/spcare-2022-003713

PMID:36041821

Abstract

OBJECTIVE

We aimed to develop and validate a new emergency triage tool for use on patients with cancer undergoing palliative care (PC).

METHODS

In phase I, the new tool was developed after literature review and expert committee meetings. A prospective longitudinal study in phase II assessed the interobserver reliability of the tool. In phase III, a retrospective study of administrative data, the feasibility of routine use of the new tool and the associations with hospitalisation and survival times were evaluated.

RESULTS

The palliative care triage system (PCTS) was composed of check-list items and four colour-coded categories for maximum response time. In phase II, the PCTS was independently evaluated by two nurses for 102 attendances in the emergency department of the PC unit. An absolute agreement of 87.3% and a weighted kappa of 0.81 were observed. In phase III, all 493 attendances had the PCTS assessment registered in the medical records. The PCTS categories were associated with hospital admission (p<0.001) and survival times (p<0.001).

CONCLUSION

PCTS is a feasible tool to be used in routine ED triage of patients with advanced cancer undergoing PC. It is a valid instrument for predicting hospital admission rates and survival with high interobserver concordance rates.

摘要

目的

我们旨在开发并验证一种新的急诊分诊工具，用于接受姑息治疗（PC）的癌症患者。

方法

在第一阶段，通过文献综述和专家委员会会议开发了新工具。第二阶段的一项前瞻性纵向研究评估了该工具的观察者间可靠性。在第三阶段，对管理数据进行回顾性研究，评估了新工具常规使用的可行性以及与住院和生存时间的关联。

结果

姑息治疗分诊系统（PCTS）由清单项目和四个颜色编码类别组成，用于最长响应时间。在第二阶段，两名护士对PC病房急诊科的102次就诊进行了PCTS独立评估。观察到绝对一致性为87.3%，加权kappa为0.81。在第三阶段，所有493次就诊的PCTS评估均记录在病历中。PCTS类别与住院（p<0.001）和生存时间（p<0.001）相关。