教练激活,接触并吸引患者参与预先护理规划:一项随机临床试验
Gladys M Rodriguez1, Divya A Parikh2,3, Kris Kapphahn4
1Department of Medicine, Feinberg School of Medicine at Northwestern University, Chicago, Illinois.
JAMA oncology
|May 23, 2024
概括
与仅仅临床医生级干预相比,多层次干预显著改善了晚期癌症患者的预先护理计划 (ACP) 文档. 这种方法有效地提高了非洲癌症患者的ACP率.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在癌症晚期患者中,提前护理计划 (ACP) 率特别低.
- 与仅仅临床医生级干预相比,多层次干预可能提供一种更有效的战略来加强ACP.
研究的目的:
- 评估多层次干预在改善临床医生记录的ACP在晚期生殖尿路癌症患者中的有效性.
- 为了比较多层次干预与仅仅临床医师级干预的结果.
主要方法:
- 一项随机临床试验,涉及402名患有晚期生殖尿路癌症的成年患者.
- 参与者被分配到多层次干预 (患者级教育加上临床医师培训和EHR整合) 或对照组 (仅临床医师级干预).
- 主要结果是12个月内ACP文件;次要结果包括息治疗,宿舍使用和医疗保健利用.
主要成果:
- 多层次干预组显示,与对照组 (21.6%) 相比,ACP文件编制率 (37.8%) 显著更高.
- 干预参与者增加了息治疗和住院利用率.
- 没有观察到急诊室访问的显著差异,但干预组的住院病例较少.
结论:
- 一个多层次的干预有效地提高了癌症临床医生记录的前期护理规划在患有生殖尿道癌症的患者.
- 这一战略代表了一种有前途的方法,可以提高癌症患者中ACP患者的比例,从而有可能改善终身护理协调.
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