改善老年人死亡的舒适度:一个集群随机对照试验
Kim Beernaert1, Tinne Smets1, Joachim Cohen1
1End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium; End-of-Life Care Research Group, Ghent University, Ghent, Belgium.
Lancet (London, England)
|May 21, 2017
概括
在急性老年病房的老年患者中,护士评估的护理计划 (CAREFuL) 改善了他们的舒适度. 需要进一步监测,但CAREFuL显示出提高终身护理质量的潜力.
科学领域:
- 老年医学
- 缓和护理
- 临床试验
背景情况:
- 在急性医院环境中死亡率很高,
- 超过50%的老年人死于医院,因此需要在临终阶段改善护理质量.
研究的目的:
- 评估"临终关怀计划" (CAREFuL) 在改善临终关怀的老年患者的舒适性和护理质量的有效性.
- 评估CAREFuL对急性老年护理的舒适性和症状管理的影响.
主要方法:
- 一个集群随机对照试验,涉及比利时佛兰德地区的十家医院.
- 在五家医院实施CAREFuL (护理指南,培训,文档),而在其他五家医院实施标准护理.
- 主要结局:由护士和家庭护理人员评估的舒适度 (CAD-EOLD) 和症状管理 (SM-EOLD).
主要成果:
- 与标准护理相比,CAREFuL显著改善了护士评估的舒适度 (CAD- EOLD).
- 在家庭护理人员评估的舒适度或护士或家庭护理人员的症状管理 (SM- EOLD) 中没有发现显著差异.
- 该研究包括451个病床,对CAREFuL组的132名患者和对照组的109名患者进行了评估.
结论:
- 实施CAREFuL计划可以改善急性老年病房患者的终身护理.
- 建议对CAREFuL计划进行持续监测,以进一步验证其益处.
- 虽然护士评估的舒适性有所改善,但可能需要进一步的研究来优化症状管理和家庭报告的结果.
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