Redefining Palliative Care-A New Consensus-Based Definition

被引：628

作者：

Radbruch, Lukas ^{[1
]}

De Lima, Liliana ^{[2
]}

Knaul, Felicia ^{[3
]}

Wenk, Roberto

Ali, Zipporah ^{[4
]}

Bhatnaghar, Sushma ^{[5
]}

Blanchard, Charmaine ^{[6
]}

Bruera, Eduardo ^{[7
]}

Buitrago, Rosa ^{[8
]}

Burla, Claudia

Callaway, Mary

Cege Munyoro, Esther ^{[9
]}

Centeno, Carlos ^{[10
]}

Cleary, Jim ^{[11
]}

Connor, Stephen ^{[12
]}

Davaasuren, Odontuya ^{[13
]}

Downing, Julia ^{[14
]}

Foley, Kathleen

Goh, Cynthia ^{[15
]}

Gomez-Garcia, Wendy ^{[16
]}

Harding, Richard ^{[17
]}

Khan, Quach T. ^{[18
]}

Larkin, Phillippe ^{[19
]}

Leng, Mhoira ^{[20
]}

Luyirika, Emmanuel ^{[21
]}

Marston, Joan ^{[14
]}

Moine, Sebastien ^{[22
]}

Osman, Hibah ^{[23
]}

Pettus, Katherine ^{[2
]}

Puchalski, Christina ^{[24
]}

Rajagopal, M. R. ^{[25
]}

Spence, Dingle ^{[26
]}

Spruijt, Odette ^{[27
]}

Venkateswaran, Chitra ^{[28
]}

Wee, Bee ^{[29
]}

Woodruff, Roger

Yong, Jinsun ^{[30
]}

Pastrana, Tania ^{[31
]}

机构：

[1] Univ Hosp Bonn, Dept Palliat Med, D-53127 Bonn, Germany

[2] Int Assoc Hosp & Palliat Care, Houston, TX USA

[3] Univ Miami, Inst Adv Study Amer, Coral Gables, FL 33124 USA

[4] Kenian Hosp & Palliat Care Assoc, Nairobi, Kenya

[5] All India Inst Med Sci, Dept Onco Anaesthesia & Palliat Med, New Delhi, India

[6] Univ Witwatersrand Johannesburg, Wits Ctr Palliat Care, Johannesburg, South Africa

[7] MD Anderson Canc Ctr Houston, Dept Palliat Rehabil & Integrat Med, Houston, TX USA

[8] Univ Panama, Sch Pharm, Panama City, Panama

[9] Kenyatta Natl Hosp, Pain & Palliat Care Unit, Nairobi, Kenya

[10] Clin Univ Navarra, Dept Palliat Med, Navarra, Spain

[11] IU Sch Med, IU Simon Canc Ctr, Dept Med, Indianapolis, IN USA

[12] Worldwide Hosp Palliat Care Alliance, London, England

[13] Mongolian Natl Univ Med Sci, Gen Practice & Basic Skills Dept, Ulaanbaatar, Mongolia

[14] Int Childrens Palliat Care Network, Cape Town, South Africa

[15] Natl Canc Ctr Singapore, Div Palliat Med, Singapore, Singapore

[16] Hosp Infantil Dr Robert Reid Cabral, Clin Linfomas & LMA Cuidados Paliativos & Terapia, Santo Domingo, Dominican Rep

[17] Kings Coll London, Ctr Global Hlth Palliat Care, London, England

[18] Ho Chi Minh City Oncol Hosp, Palliat Care Dept, Ho Chi Minh City, Vietnam

[19] Univ Lausanne, Inst Univ Format & Rech Soins, Lausanne, Switzerland

[20] Makerere Univ, Dept Palliat Care, Kampala, Uganda

[21] African Assoc Palliat Care, Kampala, Uganda

[22] Univ Parisse, Hlth Educ & Practices Lab, Villetaneuse, France

[23] Amer Univ, Beirut Med Ctr, Palliat & Support Care Program, Lebanon, NH USA

[24] George Washington Univ, Inst Spiritual & Hlth, Washington, DC USA

[25] Trivandrum Inst Palliat Sci, Trivandrum, Kerala, India

[26] Hope Inst Hosp, Kingston, Jamaica

[27] Australasian Palliat Link Int, Melbourne, Vic, Australia

[28] Mehac Fdn, Kochi, Kerala, India

[29] Oxford Univ Hosp, Sir Michael Sobell House, Oxford, England

[30] Korea Univ, Coll Nursing Catholic, Seoul, South Korea

[31] Univ Hosp Aachen, Dept Palliat Med, Aachen, Germany

来源：

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT | 2020年 / 60卷 / 04期

关键词：

Definition of palliative care; consensus; Delphi method; quality of life; relief of suffering; low or middle income countries;

D O I：

10.1016/j.jpainsymman.2020.04.027

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Context. The International Association for Hospice and Palliative Care developed a consensus-based definition of palliative care (PC) that focuses on the relief of serious health-related suffering, a concept put forward by the Lancet Commission Global Access to Palliative Care and Pain Relief. Objective. The main objective of this article is to present the research behind the new definition. Methods. The three-phased consensus process involved health care workers from countries in all income levels. In Phase 1, 38 PC experts evaluated the components of the World Health Organization definition and suggested new/revised ones. In Phase 2, 412 International Association for Hospice and Palliative Care members in 88 countries expressed their level of agreement with the suggested components. In Phase 3, using results from Phase 2, the expert panel developed the definition. Results. The consensus-based definition is as follows: Palliative care is the active holistic care of individuals across all ages with serious health-related suffering due to severe illness and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers. The definition includes a number of bullet points with additional details as well as recommendations for governments to reduce barriers to PC. Conclusion. Participants had significantly different perceptions and interpretations of PC. The greatest challenge faced by the core group was trying to find a middle ground between those who think that PC is the relief of all suffering and those who believe that PC describes the care of those with a very limited remaining life span. (C) 2020 The Authors. Published by Elsevier Inc. on behalf of American Academy of Hospice and Palliative Medicine.

引用

页码：754 / 764

页数：11

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