非肿瘤类患者安宁疗护服务的双向转介标准与流程研究

Study on Two-way Referral Standard and Process of Hospice Care Service for Non-tumor Patients

通过文献回顾建立5类主要非肿瘤类疾病(终末期心脏病、肺病、肝病、肾病和神经系统疾病)生理症状评估条目,共计42条。使用6级量表法设计专家咨询问卷,邀请国内权威安宁疗护专家20名进行信函式咨询。采用界值法、主成分分析法和专家集中判断法构建对应的转介指标。开展半结构化访谈,邀请区域内12名安宁疗护服务资深专家对双向转介服务流程进行讨论。最后,构建安宁中心-社区非肿瘤类患者的安宁疗护服务转介指标标准及服务流程,能有效地形成全科医生和专科医生对于安宁疗护服务准入评估、双向转介的共识,提高安宁疗护服务资源的有效利用。

Through literature review,this study established a total of 42 items to evaluate the physiological symptoms of five major non-tumor diseases(end-stage heart disease,lung disease,liver disease,kidney disease and nervous system disease).The questionnaire was designed by using 6-level scale method,and 20 domestic authoritative hospice care experts were invited for letter consultation.Boundary value method,principal component analysis method and expert centralized judgment method were used to construct the corresponding referral index.12 regional hospice care senior experts were invited to discuss the two-way referral service process by semi-structured interviews.The establishment of hospice care service referral index standard and service process for non-tumor patients in hospice center community helps reach a consensus among general medical practitioners and specialists on hospice service access evaluation and two-way referral,and apply hospice service resources effectively.