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A Review of the Essential Components of Quality Palliative Care in the Home

机译:家庭优质姑息治疗的基本组成部分综述

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摘要

>Objective: The home is an important and often preferable setting of palliative care. While much research has demonstrated the benefits of specialized palliative homecare on patient and system outcomes, there has been little delineation of the underlying components of these efficacious programs. We synthesized the essential elements of palliative homecare from a combined review of successful programs, perspectives of patients and caregivers, and views of healthcare providers in palliative care.>Methods: Five unique palliative homecare studies were included in the rapid review and synthesis—(1) systematic review of the components of efficacious programs; (2) in-depth analysis of 11 effective community-based teams; (3) survey of bereaved caregivers; (4) survey of the general public; and (5) interviews of providers and administrators. A qualitative approach was used to identify transcending themes across the studies.>Results: Six essential elements of quality palliative homecare were common across the studies: (1) Integrated teamwork; (2) Management of pain and physical symptoms; (3) Holistic care; (4) Caring, compassionate, and skilled providers; (5) Timely and responsive care; and (6) Patient and family preparedness.>Conclusions: Our metasynthesis of effective palliative homecare models, as well as, the values of those who use and provide these services, illuminates the underpinning elements of quality home-based care for patients with a life-limiting illness. However, the application of these elements must be relevant to the local community context. To create impactful, sustainable homecare programs, it is critical to capitalize on existing processes, partnerships, and assets.
机译:>目标:家庭是姑息治疗的重要且通常更可取的环境。尽管大量研究表明了专门的姑息家庭护理对患者和系统结局的益处,但几乎没有描述这些有效计划的基本组成部分。我们综合了成功方案,患者和护理人员的观点以及医护人员对姑息治疗的看法,综合了姑息家庭护理的基本要素。>方法:审查和综合-(1)对有效程序的组成部分进行系统审查; (2)深入分析11个有效的社区团队; (3)丧亲者的调查; (四)普查; (5)对提供者和管理者的访谈。 >结果:在研究中,质量姑息家庭护理的六个基本要素是常见的:(1)综合团队合作; (2)疼痛和身体症状的管理; (3)整体护理; (4)有爱心,有同情心和技术熟练的提供者; (5)及时,及时的护理; (6)患者和家庭的准备情况。>结论:我们对有效姑息家庭护理模型的综合合成,以及使用和提供这些服务的人们的价值观,阐明了优质家庭护理的基本要素照顾有生命危险的患者。但是,这些元素的应用必须与当地社区相关。要创建有影响力的,可持续的家庭护理计划,利用现有流程,合作伙伴关系和资产至关重要。

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