Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
Department of General internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
J Palliat Med. 2024 Sep;27(9):1135-1145. doi: 10.1089/jpm.2023.0664. Epub 2024 May 10.
Palliative care demands in the United States are growing amid a comparatively small workforce of palliative care clinicians and researchers. Therefore, determining research and clinical practice priorities is essential for streamlining initiatives to advance palliative care science and practice. To identify and rank palliative care research and clinical practice priority areas through expert consensus. Using a modified Delphi method, U.S. palliative care experts identified and ranked priority areas in palliative care research and clinical practice. Priorities were thematically grouped and analyzed for topic content and frequency; univariate analysis used the median of each priority item ranking, with a cutoff median of ≤8 indicating >76% agreement for an item's ranking. In total, 27 interdisciplinary pediatric and adult palliative care experts representing 19 different academic institutions and medical centers participated in the preliminary survey and the first Delphi round, and 22 participated in the second Delphi round. The preliminary survey generated 78 initial topics, which were developed into 22 priority areas during the consensus meeting. The top five priorities were (1) access to palliative care, (2) equity in palliative care, (3) adequate financing of palliative care, (4) provision of palliative care in primary care settings, and (5) palliative care workforce challenges. These expert-identified priority areas provide guidance for researchers and practitioners to develop innovative models, policies, and interventions, thereby enriching the quality of life for those requiring palliative care services.
在美国,姑息治疗的需求不断增长,而姑息治疗临床医生和研究人员的数量相对较少。因此,确定研究和临床实践的优先事项对于简化推进姑息治疗科学和实践的举措至关重要。
通过专家共识确定并对姑息治疗研究和临床实践的优先领域进行排序。
采用改良 Delphi 法,美国姑息治疗专家确定并对姑息治疗研究和临床实践中的优先领域进行了排序。优先事项按主题进行了分组和分析,以了解主题内容和频率;使用每个优先事项排名的中位数进行单变量分析,中位数≤8 表示对该事项排名的共识>76%。
共有 27 名来自 19 所不同学术机构和医疗中心的跨学科儿科和成人姑息治疗专家参加了初步调查和第一轮 Delphi 研究,22 名专家参加了第二轮 Delphi 研究。初步调查产生了 78 个初始主题,在共识会议期间将这些主题发展为 22 个优先领域。排名前五的优先事项是:(1)获得姑息治疗的机会;(2)姑息治疗的公平性;(3)姑息治疗的充足资金;(4)在初级保健环境中提供姑息治疗;(5)姑息治疗人员队伍的挑战。
这些专家确定的优先领域为研究人员和从业人员提供了指导,以开发创新模式、政策和干预措施,从而丰富需要姑息治疗服务的人群的生活质量。