論文

査読有り 国際誌
2020年3月18日

Quality indicators of palliative care for acute cardiovascular diseases.

Journal of cardiology
  • Atsushi Mizuno
  • Mitsunori Miyashita
  • Takashi Kohno
  • Yasuharu Tokuda
  • Shuhei Fujimoto
  • Masato Nakamura
  • Morimasa Takayama
  • Koichiro Niwa
  • Terunobu Fukuda
  • Shinichi Ishimatsu
  • Satomi Kinoshita
  • Shogo Oishi
  • Hiroki Mochizuki
  • Akemi Utsunomiya
  • Yasuko Takada
  • Ryota Ochiai
  • Toshiaki Mochizuki
  • Ken Nagao
  • Saran Yoshida
  • Akitoshi Hayashi
  • Ryuichi Sekine
  • Toshihisa Anzai
  • 全て表示

記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1016/j.jjcc.2020.02.010

BACKGROUND: Although recent attention to palliative care for patients with cardiovascular diseases has been increasing, there are no specific recommendations on detailed palliative care practices. We proceed on a discussion of the appropriateness and applicability of potential quality indicators for acute cardiovascular diseases according to our previous systematic review. METHODS: We created a multidisciplinary panel of 20 team members and 7 external validation clinicians composed of clinical cardiologists, a nutritionist, a physiotherapist, a clinical psychologist, a critical and emergent care specialist, a catheterization specialist, a primary care specialist, a palliative care specialist, and nurses. After crafting potential indicators, we performed a Delphi rating, ranging from "1 = minimum" to "9 = maximum". The criterion for the adoption of candidate indicators was set at a total mean score of seven or more. Finally, we subcategorized these indicators into several domains by using exploratory factor analysis. RESULTS: Sixteen of the panel members (80%) were men (age, 49.5 ± 13.7 years old). Among the initial 32 indicators, consensus was initially reached on total 23 indicators (71.8%), which were then summarized into 21 measures by selecting relatively feasible time variations. The major domains were "symptom palliation" and "supporting the decision-making process". Factor analysis could not find optimal model. Narratively-developed seven sub-categories included "presence of palliative care team", "patient-family relationship", "multidisciplinary team approach", "policy of approaching patients", "symptom screening and management", "presence of ethical review board", "collecting and providing information for decision-maker", and "determination of treatment strategy and the sharing of the care team's decision". CONCLUSION: In this study we developed 21 quality indicators, which were categorized into 2 major domains and 7 sub-categories. These indicators might be useful for many healthcare providers in the initiation and enhancement of palliative care practices for acute cardiovascular diseases in Japan.

リンク情報
DOI
https://doi.org/10.1016/j.jjcc.2020.02.010
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/32199753
ID情報
  • DOI : 10.1016/j.jjcc.2020.02.010
  • PubMed ID : 32199753

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