Llop-Medina Laura, Ródenas-Rigla Francisco, Garcés-Ferrer Jorge, Doñate-Martínez Ascensión
Polibienestar Research Institute, University of Valencia, 46022 Valencia, Spain.
Healthcare (Basel). 2022 Dec 9;10(12):2489. doi: 10.3390/healthcare10122489.
The increasing prevalence of complex chronic diseases in the population over 65 years of age is causing a major impact on health systems. This study aims to explore the needs and preferences of the multimorbid patient and carers to improve the palliative care received. The perspective of professionals who work with this profile of patients was also taken into account. A qualitative study was conducted using semi-structured interviews with open-ended questions. Separate topic guides were developed for patients, careers and health professionals. We included 12 patients, 11 caregivers and 16 health professionals in Spain. The results showed multiple unmet needs of patients and families/caregivers, including feelings of uncertainty, a sense of fear, low awareness and knowledge about palliative care in non-malignant settings, and a desire to improve physical, psychosocial and financial status. A consistent lack of specialized psychosocial care for both patients and caregivers was expressed and professionals highlighted the need for holistic needs assessment and effective and early referral pathways to palliative care. There is a lack of institutional support for multimorbid older patients in need of palliative care and important barriers need to be addressed by health systems to face the significant increase in these patients.
65岁以上人群中复杂慢性病的患病率不断上升，正对卫生系统造成重大影响。本研究旨在探索多病共存患者及其照料者的需求和偏好，以改善他们所接受的姑息治疗。同时也考虑了针对这类患者开展工作的专业人员的观点。采用带有开放式问题的半结构化访谈进行了一项定性研究。针对患者、照料者和卫生专业人员分别制定了主题指南。我们纳入了西班牙的12名患者、11名照料者和16名卫生专业人员。结果显示，患者以及家庭/照料者存在多种未满足的需求，包括不确定感、恐惧、对非恶性疾病环境下姑息治疗的认知和了解不足，以及改善身体、心理社会和经济状况的愿望。患者和照料者一致表示缺乏专门的心理社会护理，专业人员强调需要进行全面的需求评估以及建立有效的早期姑息治疗转诊途径。对于需要姑息治疗的多病共存老年患者，缺乏机构支持，卫生系统需要消除重要障碍，以应对这类患者数量的大幅增加。
