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姑息治疗与快速急诊筛查(P-CaRES)工具在德国的验证。

Validation of the Palliative Care and Rapid Emergency Screening (P-CaRES) Tool in Germany.

作者信息

Schmitz Julia, Tewes Mitra, Mathew Baicy, Bubel Marie, Kill Clemens, Risse Joachim, Huessler Eva-Maria, Kowall Bernd, Salvador Comino Maria Rosa

机构信息

Department of Palliative Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany.

Center of Emergency Medicine, University Hospital Essen, Hufelandstr. 55, 45147 Essen, Germany.

出版信息

J Clin Med. 2025 Mar 23;14(7):2191. doi: 10.3390/jcm14072191.

Abstract

: The "Palliative Care and Rapid Emergency Screening Tool" (P-CaRES) is used to identify patients with palliative needs in the emergency department. This study aims to translate, adapt, and validate the P-CaRES tool for the German healthcare context. : This is a monocentric, non-interventional, retrospective study conducted in the emergency department of the University Hospital Essen, Germany. After a structured translation process, the tool's face and content validity were evaluated using questionnaires completed by healthcare workers. Construct validity was established by comparing the results with the German-validated Supportive and Palliative Care Indicators Tool (SPICT). A palliative care physician blinded to the tool, independently assessed the screened patients, and made recommendations on the appropriateness of palliative care referrals. : Two hundred eighty-nine emergency department visits were examined. In addition, a total of 26 healthcare professionals were surveyed. 258 screenings were conducted, with P-CaRES identifying 50 positive cases (19.4%). Agreement between SPICT and P-CaRES was 88.4% (kappa: 0.67, 95% confidence interval (CI): [0.56, 0.78]), showing 64.7% sensitivity and 96.8% specificity. Expert comparison yielded 85.5% agreement (kappa: 0.54, 95% CI: [0.41, 0.68]), with 64.0% sensitivity and 90.8% specificity. Face and content validity showed strong agreement regarding the tool's design, including its comprehensibility, applicability, ease of use, and precision, as well as its usefulness in referring patients to a specialized palliative care team. : The study successfully validated a cultural and linguistic equivalent German version of the P-CaRES tool. Further research is necessary to assess the tool's effectiveness in clinical practice.

摘要

“姑息治疗与快速急诊筛查工具”(P-CaRES)用于在急诊科识别有姑息治疗需求的患者。本研究旨在针对德国医疗环境对P-CaRES工具进行翻译、改编和验证。 :这是一项在德国埃森大学医院急诊科进行的单中心、非干预性回顾性研究。经过结构化翻译过程后,使用医护人员填写的问卷对该工具的表面效度和内容效度进行评估。通过将结果与经德国验证的支持性和姑息治疗指标工具(SPICT)进行比较来确定结构效度。一名对该工具不知情的姑息治疗医生独立评估筛查的患者,并就姑息治疗转诊的适宜性提出建议。 :对289次急诊科就诊进行了检查。此外,共对26名医疗专业人员进行了调查。进行了258次筛查,P-CaRES识别出50例阳性病例(19.4%)。SPICT与P-CaRES之间的一致性为88.4%(kappa值:0.67,95%置信区间(CI):[0.56, 0.78]),灵敏度为64.7%,特异度为96.8%。专家比较的一致性为85.5%(kappa值:0.54,95%CI:[0.41, 0.68]),灵敏度为64.0%,特异度为90.8%。表面效度和内容效度在工具设计方面表现出高度一致性,包括其可理解性、适用性、易用性和精确性,以及在将患者转诊至专业姑息治疗团队方面的有用性。 :该研究成功验证了P-CaRES工具的文化和语言等效德文版本。有必要进行进一步研究以评估该工具在临床实践中的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8157/11989907/04fae51d3331/jcm-14-02191-g001.jpg

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