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終末期医療の質:患者の視点
P A Singer1, D K Martin, M Kelner
1Toronto Hospital and the Department of Medicine, Joint Centre for Bioethics, University of Toronto, Ontario, Canada. peter.singer@utoronto.ca
JAMA
|January 23, 1999
まとめ
患者は,疼痛管理,長期間死亡を避ける,コントロールを維持し,負担を軽減し,関係を強化することによって,質の高い終末期ケアを定義します. これらの患者中心の領域は,終末期医療の質を改善するために不可欠です.
科学分野:
- 緩和ケアとは,緩和ケアです.
- 患者中心の医療
- 質的健康研究 質的健康研究
背景:
- 終末期医療の質は,医療従事者の倫理的義務である.
- 終末期医療の質に関する患者の見解は,十分に研究されていない.
- 患者のニーズを理解することは,倫理的な医療の提供に不可欠です.
研究 の 目的:
- 患者の観点から,質の高い終末期医療の重要な要素を特定し,記述する.
- 終末期介護の患者中心の枠組みを提供すること.
- 終末期介護に関する保健医療の実践と政策を伝える.
主な方法:
- 質的調査は,深入で開かれたインタビューを用いて行われます.
- 参加者インタビューの内容分析.
- 3つの異なる患者グループ:透析,HIV,および長期介護の住人の126人の参加者が参加しました.
主要な成果:
- 患者の視点から,質の高い終末期医療の5つのコアドメインが生まれました.
- これらの領域には,適切な痛みと症状管理が含まれます.
- 他の重要な領域は,不適切な死期延長を避けること,コントロールの感覚を得ること,負担を軽減すること,愛する人と関係を強化することです.
結論:
- 特定されたドメインは,終末期医療の質を高めるために患者中心の視点を提供します.
- これらの発見は,ターゲットを絞った介入とケア戦略の開発を導くことができます.
- 患者によって定義されたこれらの要素に焦点を当てることは,倫理的で効果的な終末期ケアに不可欠です.
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