北京协和医院安宁缓和医疗门诊实践
Outpatient Clinic Practice of Hospice and Palliative Care in Peking Union Medical College Hospital
查看参考文献23篇
|
文摘
|
目的总结北京协和医院老年医学科门诊接诊安宁缓和医疗病例的情况。方法回顾性分析2016年1月1日至2019年12月31日在北京协和医院老年医学科门诊N医生处连续接诊患者的门诊资料,记录整理其中85岁以上、恶性肿瘤晚期、非肿瘤性慢性脏器疾病导致功能不全或原发病没有有效治疗方法患者的基本信息、症状、就诊目的和给予的处置。结果共接诊并记录有缓和医疗需求的患者1388例,其中,男712例(51.3%),平均年龄(69.7 ± 13.5)岁(8 ~ 105岁),60岁以上患者占73.3%。其中,63.4%的患者是专门寻求缓和医疗帮助前来就诊,87.2%是因为恶性肿瘤晚期引发的痛苦来就诊。在221例非肿瘤性疾病患者中,衰弱和神经系统退行性疾病是最主要病因。在记录到的5483个症状中,疼痛(21.2%) 、纳差(13.1%) 、乏力(11.6%) 、便秘(6.9%) 、失眠(4.6%) 、腹胀(4.6%)是最常见的6个症状。在共计2502例次的就诊中,26.2%患者为多次就诊;在多次就诊的患者中,50.3%患者就诊次数大于等于3次。患者本人来就诊的比例为38.6%,65.7%的就诊是2位及以上家人(包括患者)参与。就诊时长平均为(19.6 ± 8.5) min (2 ~ 85 min),其中,10 min以内、11 ~ 20 min、21 ~ 30 min和超过30 min结束诊疗的比例分别为13.5%、53.0%、25.6%和7.9%。结论在北京协和医院老年医学科门诊患者中,有缓和医疗需求的患者比例很高。在老年医学科门诊提供安宁缓和医疗服务是可行的。 |
|
其他语种文摘
|
Objective To share the outpatient clinic practice of hospice and palliative care at the Department of Geriatrics,Peking Union Medical College Hospital. Methods We conducted a retrospective analysis on the consecutive clinic data of doctor N in Geriatric Outpatient Clinic,Peking Union Medical College Hospital from January 1,2016 to December 31,2019. The patients aged 85 years and older,as well as those with end stage malignant tumor,non-tumor dysfunction due to chronic diseases or primary diseases without effective treatment were defined as patients with palliative care need. The basic information,symptoms,consultation purposes and treatments of these patients were collected. Results Among the 2502 visits during the study period,1388 patients with palliative care needs were admitted and recorded,with an average age of (69.7 ± 13.5) years (8 - 105 years),among which 73.3% were patients over 60 years old and 712 (51.3%) were males. Among these patients,63.4% visited specifically to seek for palliative care service and 87.2% of the visits were due to distress caused by advanced malignant tumors. Of the 221 patients with non-tumor diseases,frailty and neurodegenerative diseases were the leading life-threating cause. Of the 5483 symptoms recorded,pain (21.2%),anorexia (13.1%),fatigue (11.6%),constipation (6.9%),insomnia (4.6%),and abdominal distension (4.6%) were the six common symptoms. In the 2502 visits,26.2% of the patients had mutiple visits,and 50.3% of the patients with multiple visits had more than three visits; 38.6% of patients visited the clinic themselves,and 65.7% of visits were attended by two or more family members (including the patients). The average duration of visit was (19.6 ± 8.5) min (2 - 85 min),and 13.5%,53.0%,25.6% and 7.9% of the patients completed the consultation within 10,11 -20,21 -30 and over 30 min,respectively. Conclusion There is strong demand of palliative care in the outpatient clinic of Department of Geriatrics in Peking Union Medical College Hospital and it is feasible to provide palliative care service for patients with serious diseases in geriatric outpatient clinics. |
|
来源
|
中国医学科学院学报
,2021,43(1):3-8 【核心库】
|
|
DOI
|
10.3881/j.issn.1000-503x.13563
|
|
关键词
|
缓和医疗
;
安宁疗护
;
门诊
;
三甲医院
|
|
地址
|
中国医学科学院北京协和医学院北京协和医院老年医学科, 北京, 100730
|
|
语种
|
中文 |
|
文献类型
|
研究性论文 |
|
ISSN
|
1000-503X |
|
学科
|
内科学 |
|
文献收藏号
|
CSCD:6932390
|
参考文献 共
23
共2页
|
|
1.
Connor S R.
Global atlas of palliative care at the end of life. 2nd ed,2014
|
CSCD被引
1
次
|
|
|
|
|
2.
Candy B. Hospice care delivered at home,in nursing homes and in dedicated hospice facilities: A systematic review of quantitative and qualitative evidence.
Int J Nurs Stud,2011,48(1):121-133
|
CSCD被引
3
次
|
|
|
|
|
3.
Casarett D J. Does a palliative care clinic have a role in improving end-of-life care? Results of a pilot program.
J Palliat Med,2002,5(3):387-396
|
CSCD被引
1
次
|
|
|
|
|
4.
Kamal A H. Community-based palliative care: the natural evolution for palliative care delivery in the U. S.
J Pain Symptom Manage,2013,46(2):254-264
|
CSCD被引
2
次
|
|
|
|
|
5.
Hughes M T. The growth of palliative care in the United States.
Annu Rev Public Health,2014,35:459-475
|
CSCD被引
5
次
|
|
|
|
|
6.
. 国家卫生计生委办公厅关于印发安宁疗护实践指南(试行)的通知.
中华人民共和国国家卫生和计划生育委员会公报,2017,2:53-73
|
CSCD被引
1
次
|
|
|
|
|
7.
. 关于建立完善老年健康服务体系的指导意见.
中华人民共和国国家卫生健康委员会公报,2019,10:18-21
|
CSCD被引
2
次
|
|
|
|
|
8.
De Conno F. Palliative care at the National Cancer Institute of Milan.
Supportive Care Cancer,2001,9(3):141-147
|
CSCD被引
1
次
|
|
|
|
|
9.
Higginson I J. Social and clinical determinants of preferences and their achievement at the end of life: prospective cohort study of older adults receiving palliative care in three countries.
BMC Geriatr,2017,17(1):271
|
CSCD被引
2
次
|
|
|
|
|
10.
Kao C Y. Effects of the hospitalbased palliative care team on the care for cancer patients: An evaluation study.
Int J Nurs Stud,2014,51(2):226-235
|
CSCD被引
3
次
|
|
|
|
|
11.
Woitha K. Integration and utilization of physiotherapy in hospice and palliative care: A survey on clinical practice in Germany.
Schmerz (Berlin),2017,31(1):62-68
|
CSCD被引
1
次
|
|
|
|
|
12.
Benton K. Development and evaluation of an outpatient palliative care clinic.
J Hosp Palliat Nurs,2019,21(2):160-166
|
CSCD被引
2
次
|
|
|
|
|
13.
Smith A K. The diverse landscape of palliative care clinics.
J Palliat Med,2013,16(6):661-668
|
CSCD被引
1
次
|
|
|
|
|
14.
Allsop M J. Duration and determinants of hospice-based specialist palliative care: A national retrospective cohort study.
Palliat Med,2018,32(8):1322-1333
|
CSCD被引
1
次
|
|
|
|
|
15.
Fulton J J. Integrated outpatient palliative care for patients with advanced cancer: A systematic review and meta-analysis.
Palliat Med,2019,33(2):123-134
|
CSCD被引
5
次
|
|
|
|
|
16.
Scheffey C. Clinicbased outpatient palliative care before hospice is associated with longer hospice length of service.
J Pain Symptom Manage,2014,48(4):532-539
|
CSCD被引
2
次
|
|
|
|
|
17.
Finlay E. Models of outpatient palliative care clinics for patients with cancer.
J Oncol Pract,2019,15(4):187-193
|
CSCD被引
2
次
|
|
|
|
|
18.
宁晓红. 中国大陆应该大力发展安宁缓和医疗事业-北京协和医院的经验体会.
中国医学伦理学,2019,32(3):293-298,318
|
CSCD被引
9
次
|
|
|
|
|
19.
Huen K. Outcomes of an integrated urology-palliative care clinic for patients with advanced urological cancers: maintenance of quality of life and satisfaction and high rate of hospice utilization through end of life.
Am J Hosp Palliat Care,2019,36(9):801-806
|
CSCD被引
2
次
|
|
|
|
|
20.
Caraceni A. Outpatient palliative care and thoracic medical oncology: Referral criteria and clinical care pathways.
Lung Cancer (Amsterdam),2020,139:13-17
|
CSCD被引
1
次
|
|
|
|
|
了解气象卫星更多信息，请访问