背景:最近的柳叶刀委员会呼吁在哥伦比亚等低收入和中等收入(LMIC)国家进行更多的姑息治疗研究。全球卫生研究论坛建议采用研究重点确定方法,以解决LMIC和高收入国家之间在研究产出方面的巨大差距,有影响力的卫生服务机构建议非研究专家利益相关者积极参与建立研究优先事项,以满足服务用户的需求。
方法:遵循詹姆斯林德联盟方法的四个阶段的优先级设置伙伴关系(PSP);建立伙伴关系,识别证据的不确定性,精炼问题和不确定性,和优先次序。使用描述性统计分析来自MS形式的数据。
结果:共有33名利益相关者参加了一个在线PSP研讨会,并在MicrosoftTeams中完成了Mentimeter练习。共有48人参加了随后在波哥大城市(n=22)和Popayan农村(n=25)进行的个人优先排序活动。利益相关者是一群多样化的卫生专业人员(医生,医学生,护士,牙医,物理治疗师,营养学家,职业和言语治疗师),财务和行政人员以及患有限制生命的疾病和护理人员的患者。研究重点包括患者和护理人员的需求,服务提供商的教育和培训,以及更好地将姑息治疗与癌症和非癌症服务相结合。主要挑战包括对姑息治疗研究缺乏兴趣,加上资金,时间和资源的限制。关键解决方案包括跨学科和设置的协作,强调姑息研究的好处,以帮助获得足够的资源,多中心,混合方法研究,从研发阶段就有患者参与。
结论:本PSP的研究结果应在全球姑息治疗协会中传播,为国际多中心研究提供信息,以及促进哥伦比亚研究的政府和非政府组织。应优先关注哥伦比亚的患者和家庭护理人员姑息治疗需求。
BACKGROUND: A recent Lancet commission called for more research on palliative care in low- and middle-income (LMIC) countries such as Colombia. A research priority setting approach has been recommended by The Global Forum for Health Research to address the huge gap in research output between LMIC and high-income countries, with influential health service bodies recommending the active involvement of non-research expert stakeholders in establishing research priorities to address service user needs.
METHODS: Priority setting partnership (PSP) following the four stages of the James Lind Alliance methodology; establishing the partnership, identifying evidence uncertainties, refining questions and uncertainties, and prioritization. Data from MS forms were analysed using descriptive statistics.
RESULTS: A total of 33 stakeholders attended an online PSP workshop and completed the Mentimeter exercise in Microsoft Teams. A total of 48 attended the subsequent in person prioritisation exercise in urban Bogota (n = 22) and rural Popayan (n = 25). The stakeholders were a diverse group of health professionals (physicians, medical students, nurses, dentists, physiotherapists, nutritionist, occupational and speech therapists), financial and administrative staff and patients with life-limiting illness and caregivers. Top research priorities included patient and caregiver needs, service provider education and training, and better integration of palliative care with cancer and non-cancer services. The key challenges included a lack of interest in palliative care research, along with funding, time and resource constraints. Key solutions included collaboration across disciplines and settings, highlighting benefits of palliative research to help secure adequate resources, and multicentre, mixed method research, with patient involvement from the research development stage.
CONCLUSIONS: The findings of this PSP should be disseminated among palliative care associations worldwide to inform international multicentre studies, and among governmental and nongovernmental organisations that promote research in Colombia. A focus on patient and family caregiver palliative care needs in Colombia should be prioritised.