高齢者向け総合ケア (PACE) プログラムにおけるスタッフによる緩和ケアニーズ:調査調査
Molly A Nowels1, Karolina Sadowska1, Mark A Unruh2
1Division of Geriatrics and Palliative Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York, USA.
Journal of the American Medical Directors Association
|August 31, 2025
まとめ
PACE (オールインクルーシブ・ケア・フォー・ザ・エルダー) の臨床医は,特に事前ケア計画と行動健康において,患者の満たされていない緩和ケア需要を高く見ています. 患者の生活の質を改善するために 緩和ケアへのアクセスを拡大したいのです
科学分野:
- 高齢者医療
- 緩和ケア
- 医療サービス研究
背景:
- 地域社会における高齢者向け総合ケアプログラム (PACE) は,施設化防止を目的として,地域社会における高齢者向け総合サービスを提供しています.
- PACEの参加者はしばしば,専門的なケアコーディネーションを必要とする複雑な医療,社会的,行動的健康ニーズを持っています.
- 緩和ケアへの統合は 症状の管理と生活の質の改善に不可欠です
研究 の 目的:
- PACE患者の満たされていない緩和医療のニーズに対する提供者の認識を評価する.
- PACEの多学科スタッフのための緩和ケア教育要件を特定する.
- PACEプログラム内の緩和ケア提供の強化のための戦略を伝える.
主な方法:
- 3つのPACEサイトで臨床スタッフに横断調査が行われました.
- 参加者には医師,看護師,ソーシャルワーカー,セラピスト,認定看護助手などがいました.
- 患者のニーズとスタッフの教育上のギャップに関する調査の回答を分析するために,記述的な統計が使用されました.
主要な成果:
- 81人の回答者の半数以上は 緩和ケアが患者の生活の質を向上させると信じており 治療の機会を増やすことを望んでいます
- 緩和ケア専門家のサポートに必要な主な患者には,痛み管理,介護者サポート,精神症状管理が含まれています.
- 回答者は,PACE患者は,介護者支援,事前ケア計画,精神症状管理などの追加のサービスから最も恩恵を受けると述べた.
結論:
- PACEの臨床医は緩和医療の利点を認識していますが,特に事前のケア計画と心理社会的領域において,患者のニーズを満たすことに挑戦しています.
- 介護者支援と精神症状管理の需要が高く,PACE参加者の複雑なケア需要を強調しています.
- 統合された行動的健康緩和ケアモデルは,PACE内のこれらの複雑なニーズに対応するために,従来のコンサルティングモデルよりも効果的かもしれません.
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