Research priorities for palliative and end-of-life care in the emergency setting.
Research priorities for palliative and end-of-life care in the emergency setting.
复制标题
DOI：
10.1111/j.1553-2712.2011.01088.x
复制
发表时间：
2011-06-01
期刊：
影响因子：
--
通讯作者：
Pines, Jesse M
中科院分区：
文献类型：
--
作者：
Quest, Tammie E;Asplin, Brent R;Pines, Jesse M
姑息治疗侧重于从潜在危及生命的疾病的诊断到治愈或死亡的身体、精神、心理和社会护理。当无法治愈且生命即将结束时，姑息治疗的强度就会增强，以提供最高质量的护理体验。急诊室 (ED) 经常在姑息治疗的临终阶段照顾患者和家属。姑息治疗和紧急护理之间的交叉点继续得到更加明确的界定。目前，有越来越多的证据可以指导改善急诊科姑息治疗和临终关怀的最有效策略。在 2009 年医疗保健研究和质量机构 (AHRQ)/美国急诊医师学院 (ACEP) 会议“提高整个连续体中急诊护理的质量和效率：系统方法”的工作组会议上，出现了四个关键研究问题：1) 哪些患者最需要急诊科的姑息护理服务，2) 急诊临床医生在护理慢性病患者中的最佳作用是什么？疾病，3) 急诊室中姑息治疗培训和服务的整合和启动如何影响医疗保健的利用，以及 4) 姑息治疗领域的紧急临床提供者的教育重点是什么？工作组领导者建议，这四个关键问题可以通过使用六类询问来加强证据来回答：描述性、态度、筛查、结果、资源分配和临床医生教育。
Palliative care focuses on the physical, spiritual, psychological, and social care from diagnosis to cure or death of a potentially life-threatening illness. When cure is not attainable and end of life approaches, the intensity of palliative care is enhanced to deliver the highest quality care experience. The emergency department (ED) frequently cares for patients and families during the end-of-life phase of the palliative care continuum. The intersection between palliative care and emergency care continues to be more clearly defined. Currently, there is a mounting body of evidence to guide the most effective strategies for improving palliative and end-of-life care in the ED. In a workgroup session at the 2009 Agency for Healthcare Research and Quality (AHRQ)/American College of Emergency Physicians (ACEP) conference "Improving the Quality and Efficiency of Emergency Care Across the Continuum: A Systems Approach," four key research questions arose: 1) which patients are in greatest need of palliative care services in the ED, 2) what is the optimal role of emergency clinicians in caring for patients along a chronic trajectory of illness, 3) how does the integration and initiation of palliative care training and services in the ED setting affect health care utilization, and 4) what are the educational priorities for emergency clinical providers in the domain of palliative care? Workgroup leaders suggest that these four key questions may be answered by strengthening the evidence using six categories of inquiry: descriptive, attitudinal, screening, outcomes, resource allocation, and education of clinicians.