Development of a practice guideline for optimal symptom relief for patients with pneumonia and dementia in nursing homes using a Delphi study

Autor: Maaden, T. van der, Steen, J.T. van der, Vet, H.C.W. de, Achterberg, W.P., Boersma, F., Schols, J.M.G.A., Berkel, J.F.J.M. van, Mehr, D.R., Arcand, M., Hoepelman, A.I.M., Koopmans, R.T.C.M., Hertogh, C.M.P.M.
Přispěvatelé: General practice, Epidemiology and Data Science, EMGO - Quality of care, Health Services Research, Family Medicine, RS: CAPHRI School for Public Health and Primary Care, RS: CAPHRI - R1 - Ageing and Long-Term Care, RS: Academische Werkplaats Ouderenzorg
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Zdroj: International Journal of Geriatric Psychiatry, 30(5), 487-496
International Journal of Geriatric Psychiatry, 30(5), 487-496. John Wiley and Sons Ltd
International Journal of Geriatric Psychiatry, 30(5), 487-496. Wiley
van der Maaden, T, van der Steen, J T, de Vet, H C W, Achterberg, W P, Boersma, F, Schols, J M G A, van Berkel, J F J M, Mehr, D R, Arcand, M, Hoepelman, A I M, Koopmans, R T C M & Hertogh, C M P M 2015, ' Development of a practice guideline for optimal symptom relief for patients with pneumonia and dementia in nursing homes using a Delphi study ', International Journal of Geriatric Psychiatry, vol. 30, no. 5, pp. 487-496 . https://doi.org/10.1002/gps.4167
ISSN: 0885-6230
DOI: 10.1002/gps.4167
Popis: ObjectiveThis study aimed to develop a practice guideline for a structured and consensus-based approach to relieve symptoms of pneumonia in patients with dementia in nursing homes. MethodsA five-round Delphi study involving a panel consisting of 24 experts was conducted. An initial version of the practice guideline was developed with leading representatives of Dutch University Medical Centers with a department for elderly care medicine, based on existing guidelines for palliative care. The experts evaluated the initial version, after which we identified topics that reflected the main divergences. The experts rated their agreement with statements that addressed the main divergences on a 5-point Likert scale. Consensus was determined according to pre-defined criteria. The practice guideline was then revised according to the final decisions made by the project group and the representatives. ResultsThe response rate for the expert panel was 67%. Main divergences included the applicability of guidelines for palliative care to patients with dementia and pneumonia in long-term care and the appropriateness of specific pharmacological treatment of dyspnea and coughing. Moderate consensus was reached for 80% of the statements. Major revisions included adding pharmacological treatment for coughing and recommending opioid rotation in the case of opioid-induced delirium. Two areas of divergent opinion remained: the usefulness of oxygen administration and treatment of rattling breath. The project group made the final decision in these areas. ConclusionsWe developed a mostly consensus-based practice guideline for patients with dementia and pneumonia and mapped controversial issues for future investigation. Copyright (c) 2014 John Wiley & Sons, Ltd.
Databáze: OpenAIRE
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