Evaluation of Preoperative Acceptance of Proactive Palliative Care Intervention
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 100
- 试验地点
- 1
- 主要终点
- Acceptance of the preoperative palliative counseling offer
研究概览
简要总结
Advances in medicine have led to an increased life expectancy even with complex disease courses of malignant diseases.
This leads to frequent critical situations for patients and high risk surgical interventions. The majority of patients and their practitioners are not prepared for the consequences of a complex and possibly fatal course.
Palliative medicine makes it possible to anticipate the further course of the disease. As a result, palliative medicine has become increasingly important. The beginning of palliative medical interventions has extended from accompaniment limited to the dying phase to earlier phases of the disease.
An early integration of palliative medicine showed a positive effect on the quality of life, the degree of depression and survival in patients suffering from cancer, for example. Furthermore, patients were more able to accept a change in therapy goal at the end of life. Similar results were shown for patients with a non-malignant severe disease such as COPD or heart failure.
What needs further investigating is how to adequately screen and identify the patient populations who could benefit from early palliative care, so that they are prepared for potentially critical and life-threatening situations.
The investigator's objective is therefore whether the Anesthesiology Outpatient Clinic is a suitable screening location for initiating early integrated palliative care for patients with a serious, life-shortening illness and a high perioperative risk.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 19 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •over 18 years
- •one elective operation with medium or high cardiac risk
- •And in addition at least one of the following criteria:
- •serious comorbidity pulmonary: Emphysema and / or COPD >= 2 after GOLD cardiac: NYHA > = 2
- •and / or a metastatic malignancy
- •ASA physical status classification >= 3 and pre-frail or frail
排除标准
- •legal care
- •Emergency operation
- •any reasons which contradict inclusion in studies , e.g. cognitive deficit and lack of language skills
- •Pregnant / breastfeeding women
结局指标
主要结局
Acceptance of the preoperative palliative counseling offer
时间窗: through study completion, an average of 1 year
Percentage of patients who accept the palliative counseling offer in relation to the total number of patients identified in the screening of the anesthesia outpatient clinic
次要结局
- Therapy target decision-making situations(through study completion, an average of 1 year)
- Therapy goal decisions postoperatively(through study completion, an average of 1 year)
- Advance planning documents(through study completion, an average of 1 year)
- Postoperative palliative counseling(through study completion, an average of 1 year)
- Acceptance of the preoperative palliative counseling offer depending on the underlying disease(through study completion, an average of 1 year)
- Gender difference(through study completion, an average of 1 year)
研究者
Sascha Treskatsch
Univ.-Prof. Dr. med.
Charite University, Berlin, Germany