What is most important for you to achieve?: An analysis of patient responses when receiving palliative care consultation
What is most important for you to achieve?: An analysis of patient responses when receiving palliative care consultation
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DOI：
10.1089/jpm.2006.9.382
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发表时间：
2006-04-01
影响因子：
2.8
通讯作者：
Buckley, Marsha
中科院分区：
文献类型：
--
作者：
Quill, Timothy;Norton, Sally;Buckley, Marsha
背景资料：患有各种严重但不一定是绝症的住院病人现在正在接受姑息治疗咨询。本报告的目的是描述姑息治疗患者说是“最重要的实现”在最初的consultation.Methods：我们进行了一个回顾性的描述性内容分析的病人回答的问题“什么是最重要的，你要实现？“在首次住院姑息治疗咨询时记录。215例患者记录了第一人称患者反应。结果：这些回答被分为四个主要类别：（1）提高质量和意义（“我希望能够坐在我的前廊，看着农场走过。）（52%）;（2）获得缓解或安慰（“你能摆脱我的痛苦吗？（34%）;（3）改变疾病的轨迹（“如果有一种治疗方法可以让我好起来，我想要它。）（22%）;及（4）为死亡作准备（“我不怕死。我只是不想受苦。）（百分之十一）。5%的回答无法可靠地分类（“你问了很难的问题。").结论：接受姑息治疗咨询的患者对“你最希望达到的目标是什么”的回答范围很广。“如果患者特定的目标要成为高质量姑息治疗的标志，这种以患者为中心的优先事项调查值得在未来进行更系统的研究。
Background: Hospitalized patients with a wide range of serious, but not necessarily terminal illnesses are now receiving palliative care consultations. The purpose of this report is to describe what palliative care patients say is "most important to achieve" at the time of initial consultation.Methods: We conducted a retrospective descriptive content analysis of patient responses to the question "What is most important for you to achieve?" recorded at the time of initial inpatient palliative care consultation. Two hundred fifteen patient records had documented first-person patient responses recorded. These responses were independently reviewed and categorized in a four-phase iterative process.Results: Responses were divided into four major categories: (1) Improving quality and meaning ("I want to be able to sit on my front porch and watch the farm go by.") (52%); (2) Achieving relief or comfort ("Can you get rid of my pain?") (34%); (3) Altering the trajectory of illness ("If there is a treatment that can make me well, I want it.") (22%); and (4) Preparing for dying ("I am not afraid of dying. I just don't want to suffer.") (11%). Five percent of responses were unable to be reliably categorized ("You ask hard questions."). Some respondents gave more than one response, so the total is greater than 100%.Conclusions: Patients receiving palliative care consultation give a wide range of responses to the question "What is most important for you to achieve?" Such patient-centered inquiry about priorities deserves more systematic study in the future if patient-specific goals are to be a marker of high-quality palliative care.