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Definition and recommendations for advance care planning: an international consensus supported by the European Association for Palliative Care.
The Lancet ( IF 168.9 ) Pub Date : 2017-09-01 , DOI: 10.1016/s1470-2045(17)30582-x
Judith A C Rietjens , Rebecca L Sudore , Michael Connolly , Johannes J van Delden , Margaret A Drickamer , Mirjam Droger , Agnes van der Heide , Daren K Heyland , Dirk Houttekier , Daisy J A Janssen , Luciano Orsi , Sheila Payne , Jane Seymour , Ralf J Jox , Ida J Korfage

Advance care planning (ACP) is increasingly implemented in oncology and beyond, but a definition of ACP and recommendations concerning its use are lacking. We used a formal Delphi consensus process to help develop a definition of ACP and provide recommendations for its application. Of the 109 experts (82 from Europe, 16 from North America, and 11 from Australia) who rated the ACP definitions and its 41 recommendations, agreement for each definition or recommendation was between 68-100%. ACP was defined as the ability to enable individuals to define goals and preferences for future medical treatment and care, to discuss these goals and preferences with family and health-care providers, and to record and review these preferences if appropriate. Recommendations included the adaptation of ACP based on the readiness of the individual; targeting ACP content as the individual's health condition worsens; and, using trained non-physician facilitators to support the ACP process. We present a list of outcome measures to enable the pooling and comparison of results of ACP studies. We believe that our recommendations can provide guidance for clinical practice, ACP policy, and research.

中文翻译:

预先护理计划的定义和建议:欧洲姑息治疗协会支持的国际共识。

预先护理计划(ACP)越来越多地应用于肿瘤学及其他领域,但缺乏ACP的定义和有关其使用的建议。我们使用了正式的Delphi共识流程来帮助制定ACP的定义并提供有关其应用的建议。在对ACP定义及其41项建议进行评级的109名专家中(欧洲的82名,北美的16名,澳大利亚的11名),每种定义或建议的认可度在68%至100%之间。ACP被定义为一种能力,使个人能够确定未来医疗和护理的目标和偏好,与家庭和医疗保健提供者讨论这些目标和偏好,并在适当时记录和审查这些偏好。建议包括根据个人的准备情况调整ACP。随着个人健康状况的恶化,针对ACP内容进行定位;并且使用受过训练的非医师协助者来支持ACP流程。我们提供了一个结果度量列表,以实现ACP研究结果的汇总和比较。我们相信我们的建议可以为临床实践,ACP政策和研究提供指导。
更新日期:2017-09-04
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