Chair of Palliative Medicine, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland.
St. Lazarus Hospice, Fatimska 17, 31-831, Kraków, Poland.
Support Care Cancer. 2023 Sep 2;31(9):551. doi: 10.1007/s00520-023-08025-6.
Choosing the optimal moment for admission to palliative care remains a serious challenge, as it requires a systematic identification of persons with supportive care needs. Despite the screening tools available for referring physicians, revealing the essential information for preliminary admission triage is crucial for an undisturbed qualification process. The study was aimed at analysing the eligibility criteria for specialist palliative care disclosed within provided referrals, expanded when necessary by documentation and/or interview.
Referral forms with the documentation of 300 patients consecutively referred to the non-profit in-patient ward and home-care team in Poland were analysed in light of prognosis, phase of the disease and supportive needs.
Half of the referrals had the sufficient information to make a justified preliminary qualification based solely on the delivered documentation. The majority lacked performance status or expected prognosis. Where some information was revealed, two-thirds were in a progressing phase of the disease, with a within-weeks life prognosis. In 53.7%, no particular reason for admission was given. Social problems were signalled as the only reason for the admission in 7.7%. Twenty-eight percent were labelled as "urgent"; however, 52.4% of them were triaged as "stable" or disqualified. Patients referred to a hospice ward received complete referral forms more often, containing all necessary information.
General physicians need practical tips to facilitate timely referrals and unburden the overloaded specialist palliative care. Dedicated referral forms extended by a checklist of typical patients' concerns should be disseminated for better use of these resources.
选择最佳的时间进入姑息治疗仍然是一个严峻的挑战，因为它需要系统地识别有支持性护理需求的人。尽管有可供转诊医生使用的筛选工具，但揭示初步入院分诊所需的基本信息对于无障碍的资格认证过程至关重要。本研究旨在分析在提供的转诊中揭示的专科姑息治疗的资格标准，必要时通过文件和/或访谈进行扩展。
分析了 300 名连续转诊到波兰非营利性住院病房和家庭护理团队的转诊表，根据预后、疾病阶段和支持需求进行分析。
一半的转诊有足够的信息，仅根据提供的文件就可以进行合理的初步资格认证。大多数缺乏表现状态或预期的预后。在提供的信息中，三分之二处于疾病进展阶段，预计生存时间为数周。53.7%的转诊没有特别的入院原因。社会问题被标记为唯一的入院原因，占 7.7%。28%被标记为“紧急”；然而，其中 52.4%被归类为“稳定”或不合格。被转诊到临终关怀病房的患者更经常收到完整的转诊表，其中包含所有必要的信息。
普通医生需要实用的提示，以方便及时转诊，并减轻专科姑息治疗的负担。应传播专门的转诊表，并附有典型患者关注问题的清单，以更好地利用这些资源。
