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Development of an effective home palliative care system that adopts a multidisciplinary team approach

采用多学科团队方法开发有效的家庭姑息治疗系统

基本信息

批准号：
18590503
负责人：
SHIMOZUMA Kojiro
金额：
$ 2.55万
依托单位：
Ritsumeikan University (2007)University of Marketing and Distribution Sciences (2006)
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2006
资助国家：
日本
起止时间：
2006 至 2007
项目状态：
已结题

项目摘要

This study looked at the team approach to home palliative care for terminal cancer patients that has been pioneered in Okayama over the past several years (Okayama palliative care model), This team approach involves personnel from multiple disciplines. In this study, we first clarified the appropriate conditions for smooth implementation of the model from a qualitative study. Then, as the final outcome, we conducted a survey of satisfaction of the bereaved families.The results of the first qualitative study were: (1) regular study sessions and joint conferences with the participation of both the primary care and palliative care teams, (2) adequate sharing of information, (3) understanding by the primary team of the special type of cam provided by the palliative care team, (4) appropriate sharing of roles between the two teams, (5) respect of the primary care team, (6) emphasis on the central role of the visiting nurse station, (7) creation of an emergency system, (8) use of care insurance, and (9) cooperation with welfare professionals.Next, we first developed an official Japanese version of the FAMCARE Scale, which is a scale developed to survey the satisfaction of the bereaved families. The questionnaire was sent to 83 surviving family members of patients who had received care under the Okayama model. The mean score for the survey was 3.94 points (out of a possible 5). Responses of "satisfied" or better were received by more than 50% of respondents for nearly all items. The ratings were high for "pain relief" responses by medical specialists to questions," "physicians' response to family requests to meet and talk," "physicians' attention to symptoms," and "time taken by primary physician for patient." Conversely, issues remain in items such as "always ensuring a bed for hospitalization." Only 44% of respondents were satisfied with nursing care, suggesting the need for environmental improvements to ease the burden on families.

本研究着眼于团队方法，以家庭姑息治疗的晚期癌症患者，已率先在冈山在过去几年（冈山姑息治疗模式），这种团队方法涉及人员来自多个学科。在本研究中，我们首先从定性研究中阐明了该模式顺利实施的适当条件。然后，作为最终结果，我们对死者家属的满意度进行了调查。第一次定性研究的结果是：（1）定期举行由基层护理和姑息治疗团队共同参与的研讨会和联席会议，（2）充分分享信息，（3）基层团队了解姑息治疗团队提供的特殊类型的cam，（4）适当分担两个团队的角色;（5）尊重基层医疗团队;（6）重视巡诊护士站的中心作用;（7）建立紧急制度;（8）利用护理保险;（9）与福利专业人员的合作。接下来，我们首先开发了日本官方版的FAMCARE量表，这是一个调查丧亲家庭满意度的量表。该调查问卷被发送到83名接受冈山模式护理的患者的幸存家属。调查的平均得分为3.94分（满分为5分）。超过50%的受访者对几乎所有项目的答复都是“满意”或更好。在“缓解疼痛”方面，医疗专家对问题的回答、“医生对家属见面和交谈要求的回应”、“医生对症状的关注”和“主治医生为病人所花的时间”的评分都很高。相反，问题仍然存在于诸如“始终确保住院床位“等项目中。“只有44%的受访者对护理服务感到满意，这表明需要改善环境，以减轻家庭的负担。