Quality Indicators in Surgical Palliative Care: A Systematic Review.
Quality Indicators in Surgical Palliative Care: A Systematic Review.
复制标题
外科姑息治疗的质量指标：系统评价。
DOI：
10.1016/j.jpainsymman.2021.01.122
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发表时间：
2021
影响因子：
4.7
通讯作者：
Cooper,Zara
中科院分区：
文献类型：
--
作者：
Lee,KatherineC;Sokas,ClaireM;Streid,Jocelyn;Senglaub,StevenS;Coogan,Kathleen;Walling,AnneM;Cooper,Zara
定义外科重症患者的高质量姑息治疗对于提供以患者为中心的外科护理至关重要。专门为重病手术患者的质量指标是必要的，以整合姑息治疗到现有的外科手术质量改进programmes.ObjectivesTo确定现有的质量指标，衡量姑息治疗交付在重病手术患者，表征他们的发展，并评估其方法学质量。引导性系统评价包括报告成人手术患者姑息治疗质量指标和指南的发展过程和特征的研究。相关措施被归类到以前定义的国家共识项目领域的姑息治疗和多纳贝迪安质量框架，并评估方法quality.ResultsThere是263个独特的措施，从26项研究，其中70%的过程中的措施。最常见的指标涉及临终病人护理（31.5%）和身体护理方面（20.8%）。涉及精神方面（2.6%）和文化方面（1.2%）的指标最不常见。研究的方法质量差异很大。虽然大多数研究定义了一个目的的指标，并使用科学证据，许多研究缺乏目标人群的输入，很少有讨论的实际应用indicator.ConclusionThis审查是一个关键步骤，告知努力发展质量指标为重病手术患者。很少有指标涉及痛苦的非身体方面，也没有确定涉及姑息手术的指标。未来需要关注手术患者姑息治疗质量指标的开发和实际应用。
ContextDefining high quality palliative care in seriously ill surgical patients is essential to provide patient-centered surgical care. Quality indicators specifically for seriously ill surgical patients are necessary in order to integrate palliative care into existing surgical quality improvement programs.ObjectivesTo identify existing quality indicators that measure palliative care delivery in seriously ill surgical patients, characterize their development, and assess their methodological quality.MethodsA PRISMA-guided systematic review included studies that reported on the development process and characteristics of palliative care quality indicators and guidelines in adult surgical patients. Relevant measures were categorized into the previously defined National Consensus Project domains of palliative care and the Donabedian quality framework, and assessed for methodological quality.ResultsThere were 263 unique measures identified from 26 studies, of which 70% were process measures. Indicators addressing Care of the Patient Near the End of Life (31.5%) and Physical Aspects of Care (20.8%) were the most common. Indicators addressing Spiritual (2.6%) and Cultural Aspects of Care (1.2%) were the least common. Methodological quality varied widely across studies. Although most studies defined a purpose for the indicators and used scientific evidence, many studies lacked input from target populations and few had discussed the practical application of indicators.ConclusionThis review was a key step that informed efforts to develop quality indicators for seriously ill surgical patients. Few indicators addressed non-physical aspects of suffering and no indicators were identified addressing palliative surgery. Future attention is needed toward the development and practical application of palliative care quality indicators in surgical patients.