基于临床相关科学措施的居家姑息关怀:一项横断面研究

Ubolrat Piamjariyakul, Stephanie Young, Ann E Hendrickson, R Osvaldo Navia, Kesheng Wang, Carol E Smith
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引用次数: 0

摘要

导言衡量多种复杂疾病患者及其家属的姑息关怀需求对于提供高质量的临床关怀至关重要。综合姑息关怀结果量表(IPOS)是一种经过科学验证的衡量方法,用于衡量患者的身体和情绪症状,以及他们在姑息关怀方面的沟通和实际需求。本研究中的患者因患有临终心力衰竭(HF)和血管性痴呆而需要姑息关怀。目的:描述并比较由家庭护理人员(20 人)和患者(20 人)的 IPOS 分数衡量的家庭姑息关怀需求,并研究患者的 IPOS 总分是否能预测患者的高频健康状况和护理负担分数。研究方法本研究采用解释性研究设计,以严谨的方法从多个来源获取信息。采用描述性、Cohen's Kappa (k) 统计方法比较患者和护理者的 IPOS 分数,并采用回归分析方法研究患者 IPOS 分数对患者高频健康状况和护理负担分数的影响。结果:在 17 个 IPOS 项目中,患者和护理人员对 16 个项目的评分有明显的一致性(k = .34 至 .80)。回归分析发现,患者 IPOS 总分可显著预测患者的 HF 健康状况(β = -.50,P < .05)和护理负担评分(β = .57,P < .01)。结论患者及其照护者的 IPOS 评分一致表明,姑息关怀需求可以被一致识别。患者的 IPOS 总分可以预测患者的高频健康状况和护理负担。这些测量结果为医护人员指导居家姑息关怀提供了直接适用的信息。
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Palliative Home Care Based on Clinically Relevant Scientific Measures: A Cross-Sectional Study.

Introduction: Measuring palliative care needs of patients with multiple complex illnesses and their family, is essential for providing quality clinical care. The integrated palliative care outcome scale (IPOS) is a scientifically verified measure of patients' physical, emotional symptoms, and their palliative care communication and practical needs. The patients in this study require palliative care due to both their end-of-life heart failure (HF) and vascular dementia. Purpose: The purposes are to describe and compare home palliative care needs measured by the family caregivers (N = 20) and patients (N = 20) IPOS scores and to examine whether the patient IPOS total score can predict patient HF health status and caregiving burden scores. Methods: This study uses explanatory research design with rigorous methods for obtaining information from multiple sources. Descriptive, Cohen's Kappa (k) statistics comparing patient and caregiver IPOS scores and regression analyses to examine the patient IPOS scores impact on patient HF health status and caregiving burden scores were used. Results: There was significant agreement between patient and caregiver ratings on 16 out of 17 IPOS items (k = .34 to .80). Regression analyses found that the patient IPOS total score significantly predicted patients' HF health status (β = -.50, P < .05), and caregiving burden scores (β = .57, P < .01). Conclusion: Patients' and their caregivers' IPOS scores agreement indicates palliative care needs can be consistently identified. The patient IPOS total scores can predict patients' HF health status and caregiving burden. These measures provide information directly applicable for health professionals guiding palliative home care.

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