医生在承认住院患者的生存和息护理需求方面过于乐观:台湾的一项大型多中心研究
QJM : monthly journal of the Association of Physicians
|October 25, 2023
概括
医生经常高估患者的生存率,影响终身护理. 早期的息护理咨询至关重要,尤其是在台湾版本-息护理查工具 (TW-PCST) 得分高的情况下.
科学领域:
- 医学研究 医学研究
- 抚慰性护理是一种缓解性护理.
- 在瘤学瘤学.
背景情况:
- 医生对生命终点 (EOL) 的认可显著影响患者的结果和"良好的死亡"的经验.
- 准确的EOL评估对于及时干预和以患者为中心的护理至关重要.
研究的目的:
- 调查医生对EOL的态度.
- 分析医生评估与患者实际存活率之间的相关性.
- 评估医生评估对获得息护理咨询和服务的影响.
主要方法:
- 一项多中心的回顾性队列研究,涉及7家台湾医院的10,304名住院患者.
- 使用台湾版本 - 息护理查工具 (TW-PCST) 进行患者风险评估 (得分≥4).
- 医生们回答了有关死亡惊喜,终身认定和息护理需求的问题,随后跟踪了患者的生存率和护理准入.
主要成果:
- 在医生对死亡惊喜,EOL识别和息护理需求的评估中观察到很高的相关性.
- 被评估为接近EOL的患者的平均存活时间 (58-68天) 与未被评估为此类 (166-206天) 患者相比显著更短.
- 医生对EOL的认可受到诊断,TW-PCST得分和息护理资格的影响,而咨询访问与医生培训和疾病特征相关.
结论:
- 医生往往过于乐观地预测住院患者的生存率和确定息护理需求.
- 建议在TW-PCST得分很高时启动终生讨论.
- 建议将普遍的息护理培训纳入医学教育,以改善EOL护理.
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