緩和ケアと医学

抽象的な

An Evolutionary Concept Analysis of Palliative Care

Qiaohong Guo*, Cynthia S Jacelon and Jenna L Marquard

Aim: This paper reports a concept analysis of palliative care in the United States.
Background: There has been a significant development of palliative care in the United States. The early years of 21st century have been characterized by a proliferation of diverse models of palliative care. Methods: A review of literature was conducted to explore the development of palliative care in the United States. Retrieved articles were published in English between years 2004 and 2011. Reference lists from relevant publications were reviewed. Rodgers’s evolutionary concept analysis strategy was used to guide this paper. The matrix method was used to analyze the identified articles.
Results: The definition of palliative care has evolved in the United States in recent years. Six attributes were identified: (1) medical specialty, (2) holistic care, (3) patient- and family-centered care, (4) interdisciplinary team work, (5) effective communication, and (6) an integrated approach. The consequences of palliative care for patients, families, and medical institutions were from three aspects: (1) quality of life, (2) treatment and care, and (3) finances. The adapted palliative care model shows that palliative care should be integrated into illness management from the beginning of diagnosis and can be delivered concurrently with curative treatment through the whole trajectory of illness.
Conclusions: Both the definition and application of palliative care have evolved over the last decade. The ultimate success of developing palliative care as a medical specialty will rest upon the integration of the changing concept of palliative care into everyday practice.