Which outcome domains are important in palliative care and when? An international expert consensus workshop, using the nominal group technique
Which outcome domains are important in palliative care and when? An international expert consensus workshop, using the nominal group technique
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DOI：
10.1177/0269216319854154
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发表时间：
2019-09-01
影响因子：
4.4
通讯作者：
Murtagh, Fliss E. M.
中科院分区：
文献类型：
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作者：
de Wolf-Linder, Susanne;Dawkins, Marsha;Murtagh, Fliss E. M.
背景：在姑息治疗中获取患者水平的结果时，必须确定哪些结果领域是最重要的，并集中精力获取这些结果，以提高护理质量并将收集负担降至最低。目的：确定姑息治疗的哪些领域对于结果的测量是最重要的，以及这些领域应该被测量的最佳时间段。设计：采用名义分组技术的国际专家共识研讨会。数据被描述性地分析，并根据域的排名(1-5，最低优先级到最高优先级)进行加权。参与者选择的理由是按主题分析的。地点/参与者：共有33名在全球范围内从事姑息治疗结果评估工作的临床医生和研究人员参与。两组(n=16；n=17)各回答一个问题(无论是关于领域还是最佳时机)。该研讨会是在2016年欧洲姑息治疗协会第9届世界研究大会上举行的。结果：参与者在姑息治疗和结果测量方面的经验分别为10.9年到14.7年和5.8年到6.4年。排名最靠前的领域的平均得分(按排名加权)分别为“总体幸福感/生活质量”(2.75)、“痛苦”(2.06)和“信息需求/偏好”(2.06)。姑息措施“疾病阶段”被推荐为衡量这些领域的时间段的首选衡量标准。结论：建议定期测量“总体幸福感/生活质量”、“疼痛”和“信息需求/偏好”领域，并使用“疾病阶段”进行评估。国际上采纳这些建议将有助于标准化改善姑息治疗质量的方法。
Background: When capturing patient-level outcomes in palliative care, it is essential to identify which outcome domains are most important and focus efforts to capture these, in order to improve quality of care and minimise collection burden. Aim: To determine which domains of palliative care are most important for measurement of outcomes, and the optimal time period over which these should be measured. Design: An international expert consensus workshop using nominal group technique. Data were analysed descriptively, and weighted according to ranking (1-5, lowest to highest priority) of domains. Participants' rationales for their choices were analysed thematically. Setting/participants: In all, 33 clinicians and researchers working globally in palliative care outcome measurement participated. Two groups (n = 16; n = 17) answered one question each (either on domains or optimal timing). This workshop was conducted at the 9th World Research Congress of the European Association for Palliative Care in 2016. Results: Participants' years of experience in palliative care and in outcome measurement ranged from 10.9 to 14.7 years and 5.8 to 6.4 years, respectively. The mean scores (weighted by rank) for the top-ranked domains were 'overall wellbeing/quality of life' (2.75), 'pain' (2.06), and 'information needs/preferences' (2.06), respectively. The palliative measure 'Phase of Illness' was recommended as the preferred measure of time period over which the domains were measured. Conclusion: The domains of 'overall wellbeing/quality of life', 'pain', and 'information needs/preferences' are recommended for regular measurement, assessed using 'Phase of Illness'. International adoption of these recommendations will help standardise approaches to improving the quality of palliative care.