文章基本信息

标题：Development and Use of the ‘SENS’-Structure to Proactively Identify Care Needs in Early Palliative Care—An Innovative Approach
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作者：Monica C. Fliedner ; Geoffrey Mitchell ; Daniel Bueche 等
期刊名称：Healthcare
电子版ISSN：2227-9032
出版年度：2019
卷号：7
期号：1
页码：32-43
DOI：10.3390/healthcare7010032
出版社：MDPI Publishing
摘要：Anticipatory planning for end of life requires a common language for discussion among patients, families, and professionals. Studies show that early Palliative Care (PC) interventions based on a problem-oriented approach can improve quality of life, support decision-making, and optimize the timing of medical treatment and transition to hospice services. The aim of this quality-improvement project was to develop a pragmatic structure meeting all clinical settings and populations needs. Based on the Medical Research Council (MRC) framework, a literature review identifying approaches commonly used in PC was performed. In addition, more than 500 hospital-based interprofessional consultations were analyzed. Identified themes were structured and compared to published approaches. We evaluated the clinical usefulness of this structure with an online survey among professionals. The emerged ‘SENS’-structure stands for: Symptoms patients suffer from; End-of-life decisions; Network around the patient delivering care; and Support for the carer. Evaluation among professionals has confirmed that the ‘SENS’-structure covers all relevant areas for anticipatory planning in PC. ‘SENS’ is useful in guiding patient-centered PC conversations and pragmatic anticipatory planning, alongside the regular diagnosis-triggered approach in various settings. Following this approach, ‘SENS’ may facilitate systematic integration of PC in clinical practice. Depending on clearly defined outcomes, this needs to be confirmed by future randomized controlled studies.
关键词：chronic life-limiting condition; palliative care; patient-centered care; early palliative care intervention; advance care planning; needs assessment chronic life-limiting condition ; palliative care ; patient-centered care ; early palliative care intervention ; advance care planning ; needs assessment