文章基本信息

标题：Bolstering General Practitioner Palliative Care: A Critical Review of Support Provided by Australian Guidelines for Life-Limiting Chronic Conditions
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作者：Raechel A. Damarell ; Deidre D. Morgan ; Jennifer J. Tieman 等
期刊名称：Healthcare
电子版ISSN：2227-9032
出版年度：2020
卷号：8
期号：4
页码：553-567
DOI：10.3390/healthcare8040553
出版社：MDPI Publishing
摘要：General practitioners (GPs) are increasingly expected to provide palliative care as ageing populations put pressure on specialist services. Some GPs, however, cite barriers to providing this care including prognostication challenges and lack of confidence. Palliative care content within clinical practice guidelines might serve as an opportunistic source of informational support to GPs. This review analysed palliative care content within Australian guidelines for life-limiting conditions to determine the extent to which it might satisfy GPs’ stated information needs and support them to provide quality end-of-life care. Six databases and guideline repositories were searched (2011–2018). Eligible guidelines were those for a GP audience and explicitly based on an appraisal of all available evidence. Content was mapped against an established palliative care domain framework (PEPSI-COLA) and quality was assessed using AGREE-II. The nine guidelines meeting inclusion criteria were heterogenous in scope and depth of palliative care domain coverage. The ‘communication’ needs domain was best addressed while patient physical and emotional needs were variably covered. Spiritual, out-of-hours, terminal care and aftercare content was scant. Few guidelines addressed areas GPs are known to find challenging or acknowledged useful decision-support tools. A template covering important domains might reduce content variability across guidelines.
关键词：palliative care; general practitioners; practice guidelines as topic; uncertainty; professional competence; Australia; systematic review palliative care ; general practitioners ; practice guidelines as topic ; uncertainty ; professional competence ; Australia ; systematic review