緩和医療:紹介への障壁と,なぜリウマチ科医が電話をしないのか (まだ)
Jack Kimball1, Shannon Herndon2, Amanda M Eudy2
1Division of Geriatrics and Palliative Care, Department of Medicine, Duke University Health System, Durham, North Carolina.
Journal of pain and symptom management
|August 25, 2025
まとめ
病理学者は,不確実性や患者の誤解のために,重度の病理学的疾患の患者を緩和ケア (PC) に誘導することを躊躇しています. 緩和ケア提供者はリウマチ病の知識が不足しており,統合と最適な患者のケアを妨げています.
科学分野:
- リウマトロジ
- 緩和ケア
- 医療の統合
背景:
- 重篤なリウマチ病は高い罹病率と死亡率と関連しています.
- 緩和ケア (PC) は,潜在的利益にもかかわらず,関節病学では十分に活用されていません.
- 病理学におけるPC統合の障壁に関する知識のギャップが存在します.
研究 の 目的:
- 重篤なリウマティック疾患の患者の緩和ケアへのリファレンスの提供者固有の障壁を特定する.
- リウマチ科医と緩和ケア提供者の視点から 紹介の課題を理解する
主な方法:
- 調査は全米のリウマチ科および緩和医療提供者に配布されました.
- データは電子メールや専門会議で収集されました.
- 統計的分析には,記述的統計,フィッシャーの正確なテスト,および2つのサンプルのtテストが含まれていました.
主要な成果:
- 病理学者は,紹介のタイミングの不確実性 (50%),PCの患者の認識が"諦める" (49%) と,患者のニーズが低いと認識された (40%) を主要な障壁として挙げました.
- 緩和ケア提供者は,リウマチ病の予後 (66%),治療 (61%),疾患の進行 (53%) に関する知識の欠如を主な障害として特定しました.
結論:
- 病理学者は,いつ,どのように患者をPCに紹介するかについて,より明確なガイドラインを必要としています.
- 緩和医療の提供者は これらの患者を効果的に管理するために リウマティック疾患の理解を深める必要があります
- これらの障壁を克服することは,リウマティック疾患を持つ人々のPCへのアクセスを改善するために不可欠です.
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