Quality Indicators for Adolescents and Young Adults With Advanced Cancer: A Modified Delphi Process With Patients, Family Members, and Clinicians.
Quality Indicators for Adolescents and Young Adults With Advanced Cancer: A Modified Delphi Process With Patients, Family Members, and Clinicians.
复制标题
患有晚期癌症的青少年和年轻人的质量指标：与患者、家庭成员和临床医生一起改进的德尔菲法。
DOI：
10.1016/j.jpainsymman.2023.03.005
复制
发表时间：
2023
影响因子：
4.7
通讯作者：
Wiener,Lori
中科院分区：
文献类型：
--
作者：
Mack,JenniferW;Fisher,Lauren;Khalaj,Andrew;Altschuler,Andrea;Chao,ChunR;Kushi,LawrenceH;Casperson,Mallory;Lakin,JoshuaR;Lefebvre,Anna;Schwartz,CoreyM;Shalman,DovM;Wall,CatherineB;Wiener,Lori
背景已经为患有癌症的老年人的临终关怀制定了质量措施，但缺乏针对青少年和年轻人 (AYA) 的质量措施。 目的我们之前对 AYA、家庭护理人员和临床医生进行了访谈，以确定晚期癌症 AYA 高质量护理的优先领域。本研究的目标是使用改进的德尔菲流程就最高优先级质量指标达成共识。方法采用小组网络会议的方式，对 10 名患有复发性或转移性癌症的 AYA、11 名家庭护理人员和 29 名多学科临床医生进行了改进的德尔菲流程。参与者被要求对 41 项潜在质量指标的重要性进行评分，对最重要的 10 项进行排名，并参与讨论以协调差异。结果 在 41 项初始指标中，超过 70% 的参与者将 34 项评为高度重要（按 9 分制评分为 7、8 或 9 级）。该小组未能就 10 个最重要的指标达成共识。相反，与会者建议保留一组更大的指标，以反映整个人群不同优先事项的潜力，从而形成最终的 32 项指标。推荐指标广泛涵盖对身体症状的关注；生活质量；社会心理和精神护理；沟通和决策；与临床医生的关系；护理和治疗；结论以患者和家庭为中心的质量指标制定过程得到了德尔福参与者对多个潜在指标的强烈认可。将通过对死者家属的调查来进行进一步的验证和完善。
ContextQuality measures have been devised for end-of-life care of older adults with cancer, but are lacking for adolescents and young adults (AYAs).ObjectiveWe previously conducted interviews with AYAs, family caregivers, and clinicians to identify priority domains for high quality care of AYAs with advanced cancer. The goal of this study was to use a modified Delphi process to form consensus around the highest priority quality indicators.MethodsA modified Delphi process was conducted with 10 AYAs with recurrent or metastatic cancer, 11 family caregivers, and 29 multidisciplinary clinicians, using small group web conferences. Participants were asked to rate the importance of each of 41 potential quality indicators, rank the 10 most important, and engage in discussion to reconcile differences.ResultsOf 41 initial indicators, 34 were rated as highly important (rating seven, eight, or nine on a nine-point scale) by >70% of participants. The panel was unable to reach consensus around the 10 most important indicators. Instead, participants recommended retaining a larger set of indicators to reflect potential for different priorities across the population, resulting in a final set of 32 indicators. Recommended indicators broadly encompassed attention to physical symptoms; quality of life; psychosocial, and spiritual care; communication and decision-making; relationships with clinicians; care and treatment; and independence.ConclusionA patient- and family-centered process for quality indicator development led to strong endorsement of multiple potential indicators by Delphi participants. Further validation and refinement will be performed using a survey of bereaved family members.
登录
查看更多内容
腺苷受体亚型：结合研究
影响因子：
1.2
作者：
R. F. Bruns;G. Lu;T. Pugsley
通讯作者：
T. Pugsley
N6-(R)-苯基异丙基腺苷 (R-PIA) 激活腺苷 A1 受体可抑制大鼠纹状体突触体中毛喉素刺激的酪氨酸羟化酶活性。
影响因子：
6.1
作者：
M. Olianas;P. Onali
通讯作者：
P. Onali
DOI：
10.1007/978-3-642-45619-0
发表时间：
1987
期刊：
The Journal of Immunology
影响因子：
--
作者：
E. Gerlach;B. F. Becker
通讯作者：
B. F. Becker
腺苷和佛波酯或锂在青蛙神经肌肉接头处的相互作用
影响因子：
7.3
作者：
A. Sebastião;J. Ribeiro
通讯作者：
J. Ribeiro
DOI：
--
发表时间：
1990
期刊：
影响因子：
--
作者：
L. Gustafsson;C. Wiklund;N. Wiklund;L. Stelius
通讯作者：
L. Stelius