A Delphi study to guide the development of a clinical indicator tool for palliative care in South Africa.

Delphi study haematology indicator tool infectious diseases palliative care trauma

Journal

African journal of primary health care & family medicine
ISSN: 2071-2936
Titre abrégé: Afr J Prim Health Care Fam Med
Pays: South Africa
ID NLM: 101520860

Informations de publication

Date de publication:
19 May 2022
Historique:
received: 23 11 2021
accepted: 31 03 2022
revised: 14 03 2022
entrez: 13 6 2022
pubmed: 14 6 2022
medline: 15 6 2022
Statut: epublish

Résumé

 The South African National Policy Framework and Strategy on Palliative Care (NPFSPC) recommends that when integrating palliative care (PC) into the health system, a PC indicators tool should be used to guide clinicians to recognise a patient who should receive PC. The policy document recommends 'a simple screening tool developed for use in South Africa that would assist healthcare professionals (HCPs) to recognise patients who may have unmet palliative care needs'.  This research study sought to develop South African consensus on indicators for PC to assist clinicians to recognise a patient in need of PC.  The South African healthcare setting.  A Delphi study was considered suitable as a methodology to develop consensus. The methodology was based on the Conducting and REporting of DElphi studies (CREDES) guidance on Delphi studies to ensure rigour and transparency in conducting and reporting. Six different Delphi rounds were used to develop consensus. Each round allowed participants to anonymously rate statements with predefined rating scales.  Cognisant of the disparities in healthcare provision and access to equitable healthcare in South Africa, the expert advisory group recommended, especially for South Africa, that 'this tool is for deteriorating patients with an advanced life-limiting illness where all available and appropriate management for underlying illnesses and reversible complications has been offered'. The expert advisory group felt that disease-specific indicators should be described before the general indicators in the South African indicators tool, so all users of the tool orientate themselves to the disease categories first. This study included three new domains to address the South African context: trauma, infectious diseases and haematological diseases. General indicators for PC aligned with the original Supportive and Palliative Care Indicators Tool (SPICT) tool.  The Supportive and Palliative Care Indicators Tool for South Africa (SPICTTM-SA) is a simple screening tool for South Africa that may assist HCPs to recognise patients who may have unmet PC needs.

Sections du résumé

BACKGROUND BACKGROUND
 The South African National Policy Framework and Strategy on Palliative Care (NPFSPC) recommends that when integrating palliative care (PC) into the health system, a PC indicators tool should be used to guide clinicians to recognise a patient who should receive PC. The policy document recommends 'a simple screening tool developed for use in South Africa that would assist healthcare professionals (HCPs) to recognise patients who may have unmet palliative care needs'.
AIM OBJECTIVE
 This research study sought to develop South African consensus on indicators for PC to assist clinicians to recognise a patient in need of PC.
SETTING METHODS
 The South African healthcare setting.
METHODS METHODS
 A Delphi study was considered suitable as a methodology to develop consensus. The methodology was based on the Conducting and REporting of DElphi studies (CREDES) guidance on Delphi studies to ensure rigour and transparency in conducting and reporting. Six different Delphi rounds were used to develop consensus. Each round allowed participants to anonymously rate statements with predefined rating scales.
RESULTS RESULTS
 Cognisant of the disparities in healthcare provision and access to equitable healthcare in South Africa, the expert advisory group recommended, especially for South Africa, that 'this tool is for deteriorating patients with an advanced life-limiting illness where all available and appropriate management for underlying illnesses and reversible complications has been offered'. The expert advisory group felt that disease-specific indicators should be described before the general indicators in the South African indicators tool, so all users of the tool orientate themselves to the disease categories first. This study included three new domains to address the South African context: trauma, infectious diseases and haematological diseases. General indicators for PC aligned with the original Supportive and Palliative Care Indicators Tool (SPICT) tool.
CONCLUSION CONCLUSIONS
 The Supportive and Palliative Care Indicators Tool for South Africa (SPICTTM-SA) is a simple screening tool for South Africa that may assist HCPs to recognise patients who may have unmet PC needs.

Identifiants

pubmed: 35695438
doi: 10.4102/phcfm.v14i1.3351
pmc: PMC9210161
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e1-e7

Références

Palliat Med. 2017 Sep;31(8):684-706
pubmed: 28190381
Lancet. 2020 May 9;395(10235):1467-1469
pubmed: 32333842
Palliat Med. 2011 Sep;25(6):630-41
pubmed: 21228094
N Engl J Med. 2014 Oct 2;371(14):1344-53
pubmed: 25265493
Oncol Res Treat. 2019;42(1-2):25-30
pubmed: 30537761
J Pain Symptom Manage. 2017 Mar;53(3):509-517
pubmed: 28042069
BMJ Support Palliat Care. 2014 Sep;4(3):285-90
pubmed: 24644193
J Pain Symptom Manage. 2002 Aug;24(2):91-6
pubmed: 12231124
J Pain Symptom Manage. 2008 Nov;36(5):505-12
pubmed: 18971074

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