Measuring end-of-life care outcomes retrospectively.
Measuring end-of-life care outcomes retrospectively.
复制标题
回顾性衡量临终关怀结果。
DOI：
10.1089/jpm.2005.8.s-42
复制
发表时间：
2005
影响因子：
2.8
通讯作者：
J. Teno
中科院分区：
文献类型：
--
作者：
J. Teno
衡量临终关怀的过程和结果的基础是人们了解这种关怀的背景和明显差异。测量在临床评估、研究、质量改进和公共责任中起着重要作用。一些独特的挑战，面临的研究人员使用前瞻性研究设计，以评估质量的临终关怀可以解决与回顾性的方法或后续设计。回顾性研究避免了依赖于前瞻性地确定绝症患者的困难任务，避免给重病患者的参与者带来负担，最大限度地减少了由于功能状态差而缺失的数据，为比较护理环境创造了明确的时间框架，并且是收集关于死亡个人的基于人口的数据的具有成本效益的方法。本文回顾了使用回顾性设计的研究，并分析了与随访设计相关的信度和效度问题。虽然方法上的挑战困扰着前瞻性和回顾性的数据收集，使用这两种方法相结合或按顺序提供了一个更清晰的了解复杂的，多方面的问题，在提供护理垂死的个人。
Fundamental to measuring both the processes and outcomes of end-of-life care is that one understand the context and distinct differences of that care. Measurement plays an important role in clinical assessment, research, quality improvement, and public accountability. Some of the unique challenges that confront investigators using prospective research designs to assess quality of end-of-life care can be addressed with retrospective approaches or follow-back designs. Retrospective research avoids reliance on the difficult task of prospectively identifying the terminally ill, avoids burdening very sick participants, minimizes missing data because of poor functional status, creates a clear time frame for the purpose of comparing settings of care, and is a cost-effective way to collect population-based data about individuals who have died. This paper reviews research using a retrospective design and analyzes the reliability and validity issues associated with a follow-back design. Although methodological challenges beset both prospective and retrospective data collection, use of both methods in combination or in sequence provides a clearer understanding of the complex, multidimensional issues involved in providing care to dying individuals.