Systematic review of the problems and issues of accessing specialist palliative care by patients, carers and health and social care professionals
Systematic review of the problems and issues of accessing specialist palliative care by patients, carers and health and social care professionals
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DOI：
10.1191/0269216304pm921oa
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发表时间：
2004-01-01
影响因子：
4.4
通讯作者：
Noble, B
中科院分区：
文献类型：
--
作者：
Ahmed, N;Bestall, JC;Noble, B
目的：确定患者，非正式护理人员以及参与初级和二级医疗机构护理的卫生和社会护理专业人员获得专家姑息治疗的问题和问题。资料来源：检索了1997年初至2003年10月的11个电子数据库（医学、健康相关和社会科学）。姑息医学（1997年1月-2003年10月）也进行了手工检索。研究选择：系统搜索以英文撰写的研究报告、报告和政策文件。数据提取：对纳入的论文进行数据提取，并使用10个问题（40分制）评估每个纳入研究的质量。结果：搜索结果为9921次点击。207篇论文直接涉及症状或获得、转诊或接受姑息治疗的障碍和障碍的问题。只有40篇（19%）论文符合纳入标准。确定了获得和转诊姑息治疗的几个障碍，包括卫生和社会护理专业人员缺乏知识和教育，以及缺乏标准化的转诊标准。有些人没有及时得到转诊。例如，在一个实施例中，来自少数民族社区的人，老年人和非恶性疾病患者以及被社会排斥的人。例如，在一个实施例中，无家可归的人结论：有必要在卫生和社会护理专业人员、患者和护理人员中提高关于专科姑息治疗和临终关怀的教育和知识。需要制定标准化的转诊标准。还需要进一步开展工作，评估目前无法获得姑息治疗服务的人的需求。
Objectives: To determine the problems and issues of accessing specialist palliative care by patients, informal carers and health and social care professionals involved in their care in primary and secondary care settings. Data sources: Eleven electronic databases (medical, health-related and social science) were searched from the beginning of 1997 to October 2003. Palliative Medicine (January 1997-October 2003) was also hand-searched. Study selection: Systematic search for studies, reports and policy papers written in English. Data extraction: Included papers were data-extracted and the quality of each included study was assessed using 10 questions on a 40-point scale. Results: The search resulted in 9921 hits. Two hundred and seven papers were directly concerned with symptoms or issues of access, referral or barriers and obstacles to receiving palliative care. Only 40 (19%) papers met the inclusion criteria. Several barriers to access and referral to palliative care were identified including lack of knowledge and education amongst health and social care professionals, and a lack of standardized referral criteria. Some groups of people failed to receive timely referrals e. g., those from minority ethnic communities, older people and patients with nonmalignant conditions as well as people that are socially excluded e. g., homeless people. Conclusions: There is a need to improve education and knowledge about specialist palliative care and hospice care amongst health and social care professionals, patients and carers. Standardized referral criteria need to be developed. Further work is also needed to assess the needs of those not currently accessing palliative care services.