An evaluation of palliative care contents in national dementia strategies in reference to the European Association for Palliative Care white paper
An evaluation of palliative care contents in national dementia strategies in reference to the European Association for Palliative Care white paper
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DOI：
10.1017/s1041610215000150
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发表时间：
2015-09-01
影响因子：
7
通讯作者：
van der Steen, Jenny T.
中科院分区：
文献类型：
--
作者：
Nakanishi, Miharu;Nakashima, Taeko;van der Steen, Jenny T.
背景：痴呆症涉及许多功能领域的进行性衰退。政策和实践指南应涵盖从早期发现到生命终结的整个疾病过程。本研究旨在评估国家痴呆症战略的内容，重点关注姑息治疗内容。方法：我们采用定性内容分析。审查了来自 14 个国家的 16 项国家痴呆症战略。使用开放编码，将内容与欧洲姑息治疗协会 (EAPC) 痴呆症姑息治疗白皮书的领域和建议进行比较。结果：尽管 14 个国家中的 8 个国家没有明确提及姑息治疗，并且在 3 个国家中只在有限程度上提及姑息治疗，但 EAPC 白皮书中的许多领域得到了很好的体现，包括“以人为本的护理、沟通和共同决策”； “持续护理”；和“家庭关怀和参与”。三个明确提到姑息治疗的国家这样做了，其中两个领域得到了很好的体现：“医疗保健团队的教育”；和“社会和道德问题”。这些策略都缺乏对“死亡的预测和及时识别”以及精神护理领域的提及。结论：国家痴呆症战略涵盖了痴呆症姑息治疗的最新定义的一部分，尽管它们并不经常将这些参考标记为“姑息治疗”。鉴于死于痴呆症的人数不断增加，应将生命最后阶段的准备纳入国家战略。
Background: Dementia involves a progressive decline in many functional areas. Policy and practice guidelines should cover the entire course of the disease from early detection to the end-of-life. The present study aimed to evaluate the contents of national dementia strategies with a focus on palliative care content.Methods: We employed qualitative content analyses. Sixteen national dementia strategies from 14 countries were reviewed. Using open coding, the contents were compared to the domains and recommendations of the palliative care in dementia white paper of the European Association for Palliative Care (EAPC).Results: Although palliative care was not explicitly referred to in eight of the 14 countries and only to a limited extent in three countries, a number of domains from the EAPC white paper were well represented, including "person-centered care, communication, and shared decision making"; "continuity of care"; and "family care and involvement." Three countries that referred to palliative care did so explicitly, with two domains being well represented: "education of the health care team"; and "societal and ethical issues." The strategies all lacked reference to the domain of "prognostication and timely recognition of dying" and to spiritual caregiving.Conclusions: National dementia strategies cover part of the recent definition of palliative care in dementia, although they do not frequently label these references as "palliative care." In view of the growing numbers of people dying with dementia, preparation for the last phase of life should be added to national strategies.