RDOS-family: a guided learning tool for layperson assessment of respiratory distress.
RDOS-family: a guided learning tool for layperson assessment of respiratory distress.
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RDOS-family：用于外行评估呼吸窘迫的指导学习工具。
DOI：
10.1089/jpm.2014.0145
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发表时间：
2014
影响因子：
2.8
通讯作者：
Templin,ThomasN
中科院分区：
文献类型：
--
作者：
Campbell,MargaretL;Templin,ThomasN
尊敬的编辑：作者开发并完成了呼吸窘迫家庭评估工具的试点测试。呼吸窘迫观察量表 (RDOS) 旨在指导临床医生在无法引出患者呼吸困难自我报告时进行评估。其他地方报告了心理测量学可接受的可靠性和有效性。 1 RDOS-Family 专为家庭姑息治疗/临终关怀环境而开发，用于指导家庭护理。家庭护理人员 (FC) 接受临终关怀人员提供的有关症状管理的不同程度的培训，但他们全天候负责确保患者在临终时感到舒适。患者和家庭的结果取决于 FC 准确评估患者并提供相关干预措施的能力。人们对亲人的痛苦和症状感到内疚、绝望和愤怒，因为FC认为对症状恶化负有责任。 2 据报道，护理人员的负面结果包括抑郁、疲劳和情绪障碍。 3, 4 此外，心肺疾病的临终关怀诊断（其中呼吸困难是最常见、令人痛苦的症状）与急性入院和非首选死亡地点有关。 5我们已经完成了 RDOS-Family 的试点测试，其中包括因呼吸困难而住院的患者的家庭护理人员的方便样本。注册护士研究助理 (RA) 指导家人如何使用 RDOS-Family。随后，家属和 RA 同时独立地对患者进行评分。我们招募了 52 名成年男性和女性 (67%)，其中大多数是非裔美国人 (98%)，他们是城市三级医院收治的患者的家庭护理人员。大多数家庭护理人员是高中毕业生（67%）。年龄范围为 24 岁至 78 岁（平均 51 岁）。少数人 (27%) 拥有作为认证护士助理的正式护理经验（见表 1）。 RDOS-Family培训每人约20分钟完成。 RA 和家庭之间的 RDOS 总分没有显着差异（t=-0.96，p=0.34）。发现了强烈的显着组内相关性（ric=0.71，p<0.01）。家庭低估了心率和呼吸频率、辅助肌的使用 (p< 0.01) 以及自相矛盾的情况
Dear Editor: The authors have developed and completed pilot testing of a tool for family assessment of respiratory distress. The Respiratory Distress Observation Scaleª (RDOS) was developed to guide clinician assessment when a patient’s dyspnea self-report could not be elicited. Acceptable reliability and validity psychometrics are reported elsewhere. 1 RDOS-Family was developed for use in the home palliative care/hospice setting to guide family caregiving. Family-caregivers (FC) receive variable amounts of training from hospice personnel regarding symptom management, yet they have the around-the-clock responsibility of ensuring patient comfort at the end of life. Patient and family outcomes are dependent on the quality of FC ability to accurately assess the patient and provide the relevant interventions. Increased feelings of guilt, despair, and anger over the suffering and symptoms of their loved ones because the FC felt responsible for the worsening symptoms have been identified. 2 Negative caregiver outcomes have been reported such as depression, fatigue, and mood disturbance. 3, 4 In addition, hospice diagnoses of heart and lung disease, with dyspnea as the most prevalent, distressing symptom, are associated with acute hospital admissions and a nonpreferred site of death. 5We’ve completed pilot testing of the RDOS-Family with a convenience sample of family caregivers of patients hospitalized with conditions that produce dyspnea. Family were instructed on RDOS-Family use by a registered nurse research assistant (RA). Subsequently, the family and the RA simultaneously and independently scored the patient. We enrolled 52 adult men and women (67%), mostly African-American (98%), family caregivers of patients admitted to an urban tertiary hospital. Most family caregivers were high school graduates (67%). Ages ranged 24 to 78 years (mean= 51). A minority (27%) had formal caregiving experience as certified nurses’ aides (see Table 1). RDOS-Family training was completed in about 20 minutes per person. There were no significant differences in total RDOS scores between RA and family (t=-0.96, p= 0.34). A strong significant intraclass correlation was found (ric= 0.71, p< 0.01). Family underreported heart and respiratory rates, accessory muscle use (p< 0.01), and paradoxical