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喘不过气来是专业人士所说的吗？分析患者和专业人士的评估来自德国全国登记册

癌症的支持性护理体积22,pages1825- 1832年（2014)引用本文

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目的

Breathlessness is a common and distressing symptom in patients with advanced disease. Patients’ self-report is deemed to be the most valid method of symptom assessment. When patients are not capable of self-assessment, professionals’ assessment is often used as alternative but evidence on the validity is conflicting. The aim of this study was to compare self- and professionals’ assessment of breathlessness regarding presence and severity in patients with advanced disease.

Methods

Secondary analysis of a cross-sectional, multi-centre and nationwide register (HOspice and Palliative Care Evaluation (HOPE)). Documented inpatients from hospices and palliative care units from 2006 to 2008 who completed the self-assessed MInimal DOcumentation System (MIDOS) were included. Professionals’ assessment were based on the integrated symptom and problem checklist (symptom scores, 0–3). Cohen’s kappa (κ）用于估计“协议水平”（LOA）。

结果

分析了两千六百二十三名患者（平均年龄为66.9（SD，12.8）；女性中位数为54.4％；东部合作肿瘤学组中位数为3; 95.9％患有恶性疾病）。呼吸困难的患病率为53.4％（1,398例），专业人士的患者为53.1％（1,410名患者）。在80.9％的病例中，专业人员正确评估了存在（敏感性为81.8％；特异性为79.8％）。在65.7％的病例中正确估计了呼吸困难的严重程度。Loa很好（κ = 0.62) for the evaluation of presence of breathlessness and moderate (κ = 0.5) for the estimation of severity. The proportion of over- or underestimated scores was similar.

Conclusions

如果不可能使用患者的自我评价，症状评估的黄金标准标准，那么至少对于评估呼吸困难的存在，专业人士的评估可能是有效的选择。

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致谢

Many thanks to Gao Wei, statistician at Cicely Saunders Institute at King’s College London, for her statistical support. This study was presented as an oral presentation at the 6th Research Congress of EAPC in 2010 in Glasgow (UK) and as a poster presentation at the 8th German Palliative Care Conference in 2010 in Dresden (Germany) [33,34]。

Funding

Mundipharma支持临终关怀和姑息治疗评估（HOPE）登记册。

Conflict of interest

The authors have no conflicts of interest to declare.

作者信息

Affiliations

  1. Institute of Palliative Care (IPAC), Oldenburg, Germany

    Steffen T. Simon，Nadine Altfelder，Claudia Bausewein＆VeraWeingärtner

  2. Department of Palliative Medicine, Clinical Trials Unit (BMBF 01KN1106), and Centre for Integrated Oncology (CIO) Cologne/Bonn, University Hospital of Cologne, Cologne, Germany

    Steffen T. Simon, Vera Weingärtner & Raymond Voltz

  3. 德国Goettingen大学医学中心大学医学中心姑息医学系

    Bernd Alt-Epping & Friedemann Nauck

  4. Department for Palliative Medicine, University Hospital Munich, Munich, Germany

    Claudia Bausewein

  5. 英国伦敦伦敦国王学院姑息治疗，政策和康复系

    Claudia Bausewein

  6. Division of Palliative Medicine and Comprehensive Cancer Center CCC Erlangen-EMN, University Hospital Erlangen, Erlangen, Germany

    Christoph Ostgathe

  7. Department of Palliative Medicine, and Malteser Hospital Bonn/Rhein-Sieg, Bonn Palliative Care Centre, University Hospital Bonn, Bonn, Germany

    卢卡斯·拉德布鲁克（Lukas Radbruch）

  8. Clinical Analysis, Research and Application (CLARA), Kleinmachnow, Germany

    Gabriele Lindena

Authors
  1. Steffen T. Simon
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  2. Nadine Altfelder
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  3. Bernd Alt-Epping
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  4. Claudia Bausewein
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  5. Vera Weingärtner
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  6. 雷蒙德·沃尔兹（Raymond Voltz）
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  7. Christoph Ostgathe
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  8. 卢卡斯·拉德布鲁克（Lukas Radbruch）
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  9. Gabriele Lindena
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  10. 弗里德曼·纳克（Friedemann Nauck）
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Corresponding author

Correspondence toSteffen T. Simon.

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引用本文

Simon, S.T., Altfelder, N., Alt-Epping, B.等。喘不过气来是专业人士所说的吗？分析患者和专业人士在德国全国注册登记册中的评估。支持护理癌22,1825–1832（2014）。https://doi.org/10.1007/s00520-014-2131-5

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  • doi:https://doi.org/10.1007/s00520-014-2131-5

关键字

  • Dyspnea
  • Palliative care
  • 自我评估
  • 代理人
  • Signs and symptoms