Tripathi Khyati, Gobiet Emma, Van den Block Lieve, Van den Bossche Casper, Pivodic Lara
Vrije Universiteit Brussel (VUB) and Ghent University, End-of-Life Care Research Group, Laarbeeklaan 103, Brussels 1090, Belgium.
Vrije Universiteit Brussel (VUB) & Ghent University, End-of-Life Care Research Group, Brussels, Belgium.
Palliat Care Soc Pract. 2024 Dec 19;18:26323524241306120. doi: 10.1177/26323524241306120. eCollection 2024.
Older people who die from serious chronic disease typically experience long periods (months or years) of illness and complex fluctuations in their physical health and in their social, psychological and existential well-being. Our understanding of these end-of-life trajectories is very limited, focuses predominantly on physical function and clinical predictors and neglects inter-individual differences. A better understanding of end-of-life trajectories, including what is shared among people and what is individually specific, is needed for an optimal provision of palliative care and health services planning.
TRAJECT is a European Research Council-funded interdisciplinary project with a central aim to gain understanding of what is generalisable and what is individually specific in older people's end-of-life trajectories and in the circumstances that shape them.
Convergent mixed-methods design including a quantitative longitudinal survey study, a serial narrative study and a mortality follow-back survey.
TRAJECT applies a novel methodological and analytical framework, examining trajectories through two distinct scientific lenses, both suited for uncovering variability as well as general principles: a structured quantitative approach to capture fluctuations in a standardised way, and an experience-focused qualitative approach to study the subjective stories and meanings behind changes in health. The findings of the quantitative and qualitative methods will be integrated through triangulation and by systematically threading key findings from one method across to the other. The research is conducted in Belgium.
This project will lead to a new understanding of the varied ways in which older people's end-of-life trajectories unfold and which circumstances and experiences shape them. It will also reveal which elements of trajectories are shared across groups of people and which are individually specific. These new insights will provide a much-needed evidence base concerning groups at risk of poor well-being as they near death, which is needed to optimise palliative care practice, needs assessment, as well as health service planning.
死于严重慢性病的老年人通常会经历较长时期（数月或数年）的疾病折磨，其身体健康以及社会、心理和生存幸福感会出现复杂波动。我们对这些临终轨迹的了解非常有限，主要集中在身体功能和临床预测因素上，而忽略了个体差异。为了优化姑息治疗和卫生服务规划，需要更好地理解临终轨迹，包括人们之间的共同之处和个体的独特之处。
TRAJECT是一个由欧洲研究理事会资助的跨学科项目，其核心目标是了解老年人临终轨迹中具有普遍性的内容以及个体特有的内容，以及塑造这些轨迹的环境。
采用收敛性混合方法设计，包括定量纵向调查研究、系列叙事研究和死亡率随访调查。
TRAJECT应用了一种新颖的方法和分析框架，通过两个不同的科学视角来研究轨迹，这两个视角都适合揭示变异性和一般原则：一种结构化的定量方法，以标准化方式捕捉波动；一种以经验为重点的定性方法，研究健康变化背后的主观故事和意义。定量和定性方法的研究结果将通过三角互证法进行整合，并通过系统地将一种方法的关键发现贯穿到另一种方法中。该研究在比利时进行。
该项目将使我们对老年人临终轨迹展开的各种方式以及塑造这些轨迹的环境和经历有新的认识。它还将揭示轨迹中的哪些元素在人群中是共有的，哪些是个体特有的。这些新的见解将为临近死亡时幸福感不佳风险人群提供急需的证据基础，这对于优化姑息治疗实践、需求评估以及卫生服务规划是必要的。
