Xiao-Hong Ning
Chin Med Sci J. 2025 May 16;40(2):1-11. doi: 10.24920/004496.
: The development of modern palliative care in China began in the 1980s and is currently in an accelerating phase. However, inconsistencies in terminology and concepts have hindered policy-making, clinical practice, and academic research. The Terminology of Clinical Medicine (2023 edition) has determined Huan-He-Yi-Liao () and An-Ning-Liao-Hu () as the formal terms of "palliative care" and "hospice care", respectively. To align with these terms, this study aims to establish expert consensus definitions tailored to the Chinese context. : We systematically retrieved and collected domestic and international literature and policy documents related to the definition of palliative care, then deconstructed and analyzed the relevant conceptual elements of these definitions. Core expert panel built the initial recommended definition upon the conceptual elements and consensus definition of palliative care by the International Association for Hospice and Palliative Care (IAHPC) through two rounds of online discussions. After nomination and selection, 61 professionals in the field of palliative care in china were invited to participate in the consensus expert group. Two rounds of Delphi consultation were conducted among the consensus experts, who were asked to score their agreement using Likert scale to the items in the initial recommended definition and the definition statements of palliative care and hospice care. Agreement rate of over 80% was considered as reaching consensus for each items. The core expert panel revised the items and the statements of recommended definitions based on the results from two-round of Delphi surveys. The final recommended definitions were formulated after feedback from patient and public involvement (PPI) group members. : The response rates for the first and second rounds of Delphi survey were 83.6% and 100.0%, respectively. The agreement rate of the items and statements of the recommended definitions exceeded 90%. Accordingly, the definitions based on Chinese expert consensus are recommended. Palliative care is an active holistic approach aimed at patients of all ages suffering from life-threatening illness and their families and caregivers. It seeks to improve their quality of life by preventing, assessing, and relieving physical, psychological, social, and spiritual suffering. Hospice care is an integral part of palliative care, focusing on holistic care for patients at the end of life and their families and caregivers. Its goal is to help patients to maintain dignity and achieve a good death by alleviating physical, psychological, social, and spiritual distress without intentionally hastening or postponing death, meanwhile improve the quality of life for families and caregivers. : This study has established the Chinese expert consensus definitions of palliative care and hospice care in China, as well as the relationship between the two. The definitions highlight the holistic nature of palliative care, providing a foundation for discipline development, clinical practice, and public communication.
中国现代姑息治疗的发展始于20世纪80年代,目前正处于加速阶段。然而,术语和概念的不一致阻碍了政策制定、临床实践和学术研究。《临床医学术语(2023年版)》已将缓和医疗(Huan-He-Yi-Liao)和安宁疗护(An-Ning-Liao-Hu)分别确定为“姑息治疗”和“临终关怀”的正式术语。为了与这些术语保持一致,本研究旨在建立符合中国国情的专家共识定义。我们系统检索并收集了国内外与姑息治疗定义相关的文献和政策文件,然后对这些定义的相关概念要素进行了解构和分析。核心专家小组在国际临终关怀与姑息治疗协会(IAHPC)对姑息治疗的概念要素和共识定义的基础上,通过两轮在线讨论构建了初步推荐定义。经过提名和筛选,邀请了中国姑息治疗领域的61名专业人员参加共识专家组。在共识专家中进行了两轮德尔菲咨询,要求他们使用李克特量表对初步推荐定义以及姑息治疗和临终关怀的定义陈述中的项目进行同意程度评分。每个项目的同意率超过80%被视为达成共识。核心专家小组根据两轮德尔菲调查的结果对推荐定义的项目和陈述进行了修订。最终推荐定义是在患者和公众参与(PPI)小组成员反馈后制定的。第一轮和第二轮德尔菲调查的回复率分别为83.6%和100.0%。推荐定义的项目和陈述的同意率超过90%。因此,推荐基于中国专家共识的定义。姑息治疗是一种积极的整体方法,针对所有患有危及生命疾病的患者及其家属和照顾者。它旨在通过预防、评估和缓解身体、心理、社会和精神痛苦来提高他们的生活质量。临终关怀是姑息治疗的一个组成部分,专注于为临终患者及其家属和照顾者提供整体护理。其目标是通过减轻身体、心理、社会和精神痛苦,帮助患者保持尊严并实现善终,而不故意加速或推迟死亡,同时提高家属和照顾者的生活质量。本研究确立了中国姑息治疗和临终关怀的专家共识定义以及两者之间的关系。这些定义突出了姑息治疗的整体性,为学科发展、临床实践和公众交流奠定了基础。