关键词: 安宁疗护, 医院-社区-居家, 三级联动, 德尔菲技术, 肿瘤护理

Abstract:

Objective To establish a hospital-community-home three-level linkage palliative care service model （hereinafter referred to as palliative care service model） for patients with advanced tumor,and to promote the development of regional palliative care. Methods On the basis of the literature research and expert group meeting,the initial draft of the palliative care service model was constructed. 20 palliative care experts were invited to conduct 2 rounds of correspondence to revise the items. The constructed palliative care service model was preliminary applied in 10 cases of tumor patients. Results The effective recovery rates of 2 rounds of question-naires are 100%. The second round of expert judgment coefficients was 0.84;the degree of familiarity of the experts was 0.91;the degree of authority was 0.93;the Kendall harmonic coefficient was 0.086~ 0.193. The finally formed palliative care service model includes 7 first-level indicators（model purpose,implementation agency,organiza-tional structure and time limitation,job responsibilities and requirements,implementation methods,core service content,evaluation and continuous improvement）,24 second-level indicators,30 third-level indicators and 19 fourth-level indicators. Conclusion The palliative care service model constructed in this study is comprehensive and scien-tific,and it can provide references for the whole-process care model of patients with advanced tumors in the region.

Key words: Hospice Care, Hospital-Community-Home, Three-Level Linkage, Delphi Technology, Oncologic Nursing