Kircher Colleen E, Hanna Timothy P, Tranmer Joan, Goldie Craig E, Ross-White Amanda, Moulton Elizabeth, Flegal Jack, Goldie Catherine L
School of Nursing, Faculty of Health Sciences, Queen's University, Cataraqui Building, 92 Barrie Street, Kingston, ON, K7L 3N6, Canada.
Queen's Collaboration for Health Care Quality, A JBI Centre of Excellence, Kingston, ON, Canada.
BMC Palliat Care. 2025 Apr 4;24(1):93. doi: 10.1186/s12904-025-01712-7.
Palliative care is for people suffering from life-limiting illnesses that focuses on providing relief from symptoms and stress of illness. Previous studies have demonstrated that specialist palliative care consultation delivered earlier in the disease process can enhance patients' quality of life, reduce their symptom burden, reduce use of hospital-based acute care services and extend their survival. However, various definitions exist for the term early palliative care (EPC).
To investigate how EPC has been defined in the literature for adults with life- limiting illnesses.
This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) extension for Scoping Reviews guidelines and follows the Joanna Briggs Institution methodology for scoping reviews. The literature search was conducted using MEDLINE (Ovid), CINAHL (EBSCO), Embase (Ovid), PsycINFO (Ovid), Web of Science Core Collection, Ovid Cochrane Library, and ProQuest (Health and Medicine and Sociology Collections). All articles retrieved were screened by three independent reviewers.
153 articles met the inclusion criteria between 2008 and 2024. Five categories of definitions for EPC were created to organize definitions: (1) time-based (e.g. time from advanced cancer diagnosis to EPC initiation); (2) prognosis-based (e.g. prognosis or the 'surprise question'); (3) location-based (e.g. access point within the healthcare system such as outpatient setting); (4) treatment-based (e.g. physician's judgement or prior to specific therapies); and (5) symptom-based (e.g. using symptom intensity questionnaires). Many studies included patients with cancer (n = 103), with the most common definition category being time-based (n = 53). Amongst studies focusing on multiple or non-cancer diagnoses (n = 50), the most common definition category was symptom-based (n = 16).
Our findings provide a useful reference point for those seeking to understand the scope and breadth of existing EPC definitions in cancer and non-cancer illnesses and contemplate their application within clinical practice.
姑息治疗针对患有危及生命疾病的患者，重点是缓解疾病症状和压力。先前的研究表明，在疾病进程早期提供专科姑息治疗咨询可提高患者生活质量、减轻症状负担、减少基于医院的急性护理服务使用并延长生存期。然而，“早期姑息治疗”（EPC）一词存在多种定义。
探讨在针对患有危及生命疾病的成年人的文献中EPC是如何定义的。
本综述按照系统评价和Meta分析的首选报告项目（PRISMA）扩展版的范围综述指南进行，并遵循乔安娜·布里格斯循证卫生保健中心范围综述方法。使用MEDLINE（Ovid）、护理学与健康领域数据库（CINAHL，EBSCO）、Embase（Ovid）、心理学文摘数据库（PsycINFO，Ovid）、科学引文索引核心合集（Web of Science Core Collection）、Ovid循证医学图书馆以及ProQuest（健康与医学及社会学合集）进行文献检索。所有检索到的文章由三名独立评审员进行筛选。
2008年至2024年期间有153篇文章符合纳入标准。创建了五类EPC定义来组织这些定义：（1）基于时间的（例如从晚期癌症诊断到开始EPC的时间）；（2）基于预后的（例如预后或“意外问题”）；（3）基于地点的（例如医疗保健系统内的接入点，如门诊环境）；（4）基于治疗的（例如医生的判断或在特定治疗之前）；以及（5）基于症状的（例如使用症状强度问卷）。许多研究纳入了癌症患者（n = 103），最常见的定义类别是基于时间的（n = 53）。在关注多种或非癌症诊断的研究中（n = 50），最常见的定义类别是基于症状的（n = 16）。
我们的研究结果为那些试图了解癌症和非癌症疾病中现有EPC定义的范围和广度并考虑其在临床实践中的应用的人提供了一个有用的参考点。
