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缓和医疗与安宁疗护定义中国专家共识（2025）中文版
Enhanced Publication- Affiliations：
- Author bio：
Dr. Ning Xiaohong obtained her doctoral degree from Peking Union Medical College in 1998. She currently serves as the Chief Physician at the Department of Geriatrics and Director of the Palliative Care Center at Peking Union Medical College Hospital. She is also the Executive Chair of the China-UK Joint Training Program at the Beijing Living Will Promotion Association. She has dedicated her career to clinical practice, education, and social promotion of palliative care. She specializes in palliative and hospice care, particularly in symptom management, shared decision-making, education and training in palliative care, and public advocacy. She has published 58 articles in the field of hospice and palliative care and has authored or translated several influential books, including "Handbook of Symptom Management in Palliative Care" (Chief Editor, China Medical University Press, 2017) and "Palliative Care in Clinical Practice" (Chief Translator, China Medical University Press, 2017).E-mail: ningxh1973@foxmail.com.
- Funds：
DOI：10.24920/004496
中图分类号：收稿日期：2025-04-12，
录用日期：2025-05-04，
网络出版日期：2025-05-16，
- Accepted：
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缓和医疗定义中国专家共识工作组, 宁晓红. 缓和医疗与安宁疗护定义中国专家共识（2025）中文版[J/OL]. 中国医学科学杂志（英文）, 2025,401-11.
.Chinese Expert Consensus on the Definitions of Palliative Care and Hospice Care (2025)[J].Chinese Medical Sciences Journal,
缓和医疗定义中国专家共识工作组, 宁晓红. 缓和医疗与安宁疗护定义中国专家共识（2025）中文版[J/OL]. 中国医学科学杂志（英文）, 2025,401-11. DOI： 10.24920/004496.
.Chinese Expert Consensus on the Definitions of Palliative Care and Hospice Care (2025)[J].Chinese Medical Sciences Journal, DOI：10.24920/004496.
摘要
背景和目的
2
中国的现代缓和医疗发展源于上个世纪80年代，目前正处于加速发展期。然而，缓和医疗术语和概念不统一阻碍了政策制定、临床实践以及研究等诸多方面。2023年，《 常用临床医学名词》确立了“缓和医疗”（ palliative care）和“安宁疗护”（hospice care）的专业名词。本研究旨在基于已确立学科名词，建立符合中国语境的缓和医疗与安宁疗护定义。
方法
2
我们检索搜集国内外缓和医疗定义相关的文献和政策文件，折解和分析定义相关概念要素。5位核心专家组成员基于国际安宁缓和医疗协会（International Association for Hospice and Palliative care，IAHPC）最新版缓和医疗定义及其概念要素，经2次线上会议讨论并拟定中国缓和医疗初始推荐定义。经提名和遴选，我们邀请61位国内缓和医疗领域专业人员组建共识专家组，发放两轮德尔菲问卷函询，对缓和医疗初始推荐定义的31项条目内容和缓和医疗和安宁疗护定义文字表述的同意程度进行Likert评分。核心专家组根据德尔菲函询反馈结果修定推荐定义的条目内容和推荐定义的文字表述，以共识率超过80%为达到共识。经患者和公众参与（patient and public involvement，PPI）小组成员反馈，形成最终推荐定义。
结果
2
第一轮和第二轮德尔菲问卷调研函询的应答率分别为83.6%和100.0%。纳入推荐定义的条目和语句的共识率均超过90%。据此，我们推荐定义如下：缓和医疗是一种积极的全人照护实践，面向因危及生命的疾病而遭受痛苦的各年龄段患者及其家属和照护者，通过预防、评估和缓解其身体、心理、社会和灵性痛苦，提升患者及其家属和照护者的生命质量；安宁疗护是缓和医疗的重要组成部分，是为处于生命末期的患者及其家属和照护者提供的全人照护实践，其目标是在不刻意加速或推迟死亡的前提下，通过缓解患者的身体、心理、社会和灵性痛苦，维护患者尊严并帮助其实现善终，同时提升患者家属和照护者的生命质量。
结论
2
本研究确立了中国语境下缓和医疗和安宁疗护的中文定义，明确了缓和医疗包含安宁疗护的逻辑关系。定义强调缓和医疗是全人照护的实践，为学科发展、临床实践和公众传播奠定了基础。
Abstract
Background and Objective
2
The development of modern palliative care in China began in the 1980s and is currently in an accelerating phase. However
inconsistencies in terminology and concepts have hindered policy-making
clinical practice
and academic research. The Terminology of Clinical Medicine (2023 edition) has determined Huan-He-Yi-Liao (缓和医疗) and An-Ning-Liao-Hu (安宁疗护) as the formal terms of "palliative care" and "hospice care"
respectively. To align with these terms
this study aims to establish expert consensus definitions tailored to the Chinese context.
Methods
2
We systematically retrieved and collected domestic and international literature and policy documents related to the definition of palliative care
then deconstructed and analyzed the relevant conceptual elements of these definitions. Core expert panel built the initial recommended definition upon the conceptual elements and consensus definition of palliative care by the International Association for Hospice and Palliative Care (IAHPC) through two rounds of online discussions. After nomination and selection
61 professionals in the field of palliative care in china were invited to participate in the consensus expert group. Two rounds of Delphi consultation were conducted among the consensus experts
who were asked to score their agreement using Likert scale to the items in the initial recommended definition and the definition statements of palliative care and hospice care. Agreement rate of over 80% was considered as reaching consensus for each items. The core expert panel revised the items and the statements of recommended definitions based on the results from two-round of Delphi surveys. The final recommended definitions were formulated after feedback from patient and public involvement (PPI) group members.
Results
2
The response rates for the first and second rounds of Delphi survey were 83.6% and 100.0%
respectively. The agreement rate of the items and statements of the recommended definitions exceeded 90%. Accordingly
the definitions based on Chinese expert consensus are recommended. Palliative care is an active holistic approach aimed at patients of all ages suffering from life-threatening illness and their families and caregivers. It seeks to improve their quality of life by preventing
assessing
and relieving physical
psychological
social
and spiritual suffering. Hospice care is an integral part of palliative care
focusing on holistic care for patients at the end of life and their families and caregivers. Its goal is to help patients to maintain dignity and achieve a good death by alleviating physical
psychological
social
and spiritual distress without intentionally hastening or postponing death
meanwhile improve the quality of life for families and caregivers.
Conclusions
2
This study has established the Chinese expert consensus definitions of palliative care and hospice care in China
as well as the relationship between the two. The definitions highlight the holistic nature of palliative care
providing a foundation for discipline development
clinical practice
and public communication.
关键词
Keywords
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