息治疗中的协作预先护理规划:一个随机对照试验
Carola Seifart1, Martin Koch2, Svenja Herzog3
1Faculty of Medicine; Deans Office, Philipps-Universität Marburg, Marburg, Germany carola.seifart@staff.uni-marburg.de.
BMJ supportive & palliative care
|July 3, 2024
概括
协作预先护理计划 (ACP) 显著增加了息性癌症患者预先指示和医疗保健代理的完成. 这种方法增强了患者的自主权,并确保终身护理符合他们的愿望.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 精神瘤学 精神瘤学
背景情况:
- 预先护理计划 (ACP) 对于癌症患者的终身护理至关重要.
- 心理障碍往往阻碍了对ACP的获取和有效性.
- 一个新的模式,协作ACP (col-ACP),将精神瘤学与结构化的ACP整合在一起.
研究的目的:
- 评估col-ACP模型在息性癌症患者中的有效性和效率.
- 评估col-ACP对EOL护理一致性和患者准备程度的影响.
- 为了确定col-ACP是否影响患者和护理人员的生活质量,压力,抑郁或和平.
主要方法:
- 一项随机对照试验,涉及277名息性癌症患者及其亲属.
- 三个支部:共同ACP (精神瘤支持+标准ACP),支持性干预 (积极控制) 和标准医疗护理.
- 结果包括完成预先指示,医疗保健代理,以及患者报告的准备和对表达愿望的信心.
主要成果:
- 协同ACP组的患者显示,预先指示 (p<0.01) 和医疗代理 (p<0.01) 的完成率显著更高.
- col-ACP改善了患者对未来治疗的准备感 (p<0.01) 和他们知道他们的愿望的信心 (p=0.03).
- 没有观察到患者或护理人员组之间的生活质量,压力,抑郁或和平的显著差异.
结论:
- 该col-ACP模型有效地提高了对ACP的准备和访问,从而导致更一致的EOL护理.
- 虽然没有直接影响生活质量,但col-ACP赋予患者在治疗规划和自主决策方面的权力.
- 建议加强精神瘤和ACP服务之间的整合,以改善患者的支持.
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