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首页> 外文期刊>BMC Health Services Research >Optimal care at the end of life (OPAL): study protocol of a prospective interventional mixed-methods study with pretest-posttest-design in a primary health care setting considering the view of general practitioners, relatives of deceased patients and health care stakeholders
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Optimal care at the end of life (OPAL): study protocol of a prospective interventional mixed-methods study with pretest-posttest-design in a primary health care setting considering the view of general practitioners, relatives of deceased patients and health care stakeholders

机译：在寿命结束时（蛋白石）的最佳护理：考虑到普通科学者，死者和医疗保健利益攸关方的亲属的主要医疗保健环境中预期介入混合方法研究的前瞻性介入混合方法研究。

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At the end of life, about 85-90% of patients can be treated within primary palliative care (PC) provided by general practitioners (GPs). In Germany, there is no structured approach for the provision of PC by GPs including a systematic as well as timely identification of patients who might benefit from PC, yet. The project "Optimal care at the end of life" (OPAL) focusses on an improvement of primary PC for patients with both oncological and non-oncological chronic progressive diseases in their last phase of life provided by GPs and health care services. OPAL will take place in Hameln-Pyrmont, a rural region in Lower Saxony, Germany. Target groups are (a) GPs, (b) relatives of deceased patients and (c) health care providers. The study follows a three-phase approach in a mixed-methods and pre-post design. In phase I (baseline, t0) we explore the usual practice of providing PC for patients with chronic progressive diseases by GPs and the collaboration with other health care providers. In phase II (intervention) the Supportive and Palliative Care Indicators Tool (SPICT) for the timely identification of patients who might benefit from PC will be implemented and tested in general practices. Furthermore, a public campaign will be started to inform stakeholders, to connect health care providers and to train change agents. In phase III (follow-up, t1) we investigate the potential effect of the intervention to evaluate differences in the provision of PC by GPs and to convey factors for the implementation of SPICT in general practices. The project OPAL is the first study to implement the SPICT-DE regionwide in general practices in Germany. The project OPAL may contribute to an overall optimisation of primary PC for patients in Germany by reducing GPs' uncertainty in initiating PC, by consolidating their skills and competencies in identifying patients who might benefit from PC, and by improving the cooperation between GPs and different health care stakeholders. The study was retrospectively registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien; trial registration number: DRKS00015108 ; date of registration: 22th of January 2019).
机译：在生命结束时，大约85-90％的患者可以在一般从业者（GPS）提供的主要姑息治疗（PC）内进行治疗。在德国，GPS没有提供PC的结构化方法，包括系统的，也可以及时鉴定可能受益于PC的患者。该项目“在生命结束时的最佳护理”（蛋白石）侧重于在GPS和医疗保健服务提供的最后一期肿瘤和非肿瘤性慢性进步疾病的患者的提高。蛋白石将在德国下萨克森州的一个乡村地区的Hameln-Pyrmont举行。目标群体是（a）GPS，（b）已故患者和（c）卫生保健提供者的亲属。该研究遵循混合方法和后设计前的三相方法。在I阶段（基线，T0）中，我们探讨了通过GPS和与其他医疗保健提供者的合作提供慢性渐进性疾病的患者的常用实践。在第二阶段（干预）的支持和姑息护理指标工具（案例）将在一般实践中实施和测试，以便及时鉴定可能受益于PC的患者。此外，公共活动将开始通知利益相关者，以连接医疗保健提供者并培训改变代理人。在第三阶段（随访，T1），我们调查干预的潜在效果，评估GPS提供PC的差异，并在一般行为中传达案例的因素。项目蛋白石是第一次在德国一般实践中实施蜘蛛网的研究。项目欧宝项目可能通过减少PC在启动PC中的GPS的不确定性，通过巩固他们的技能和能力来巩固可能从PC中受益的患者以及改善GPS和不同健康之间的合作来促进德国GPS的不确定性来促进德国的患者的整体优化关心利益攸关方。该研究回顾性在德国临床试验登记册（Deutsches Register Klinischer Studen;试验登记号码：DRKS00015108;日期（注册）：2019年1月22日）。

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