終末期の病気で生きる意志
H M Chochinov1, D Tataryn, J J Clinch
1Department of Psychiatry, University of Manitoba, Winnipeg, Canada. chochin@cc.umanitoba.ca
Lancet (London, England)
|September 15, 1999
まとめ
死にかけている患者の生きる意志は,うつ病や不安などの要因の影響を受け,大きく変動します. これらの影響は,死が近づくにつれて変化し,終末期のケアに関する決定に影響を与えます.
科学分野:
- 緩和ケア医療 緩和ケア医療 緩和ケア医療
- 心理社会的腫瘍学
- 終末期の研究について
背景:
- 安楽死と助死自殺は,複雑な生物医学および心理社会的要因を伴う.
- 患者の生存意欲は,生命の終わりの介護の重要な側面ですが,まだ十分に研究されていません.
研究 の 目的:
- 死にかけている患者の生きる意志の変動を調査する.
- 時間の経過とともにこれらの変動に影響を与える要因を特定する.
主な方法:
- 緩和ケアを受けているがん患者の生存意欲を,視覚的なアナログスケールを使用して1日2回評価した.
- エドマントン症状評価システムにスケールを組み込みました.
- 生きる意志の評価の計算された最大値と中央値の変動,様々な時間間隔で.
主要な成果:
- 生存意欲の平均スコアは安定したままであったが,最大変動はかなり (30日間で68.0mmなど) であった.
- うつ病,不安,呼吸困難,幸福感は,生きる意志の主要な予測因子でした.
- これらの予測要因の影響は,死が近づくにつれて変化した.
結論:
- 死にかけている患者は,生きる意志の有意な変動を示しています.
- 生きる意志の変化の決定要因は,死ぬ過程で進化する.
関連する概念動画
Restorative Care
Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
Continuing Care
Continuing care describes the variety of health, personal, and social services provided over a prolonged period. The need for continuing care is increasing because people are living longer. Many people do not have families or others to care for them. Continuing care is mainly for patients who are disabled, functionally dependent, or suffering from a terminal disease. It is available within institutional settings or in homes. Examples include nursing centers or facilities, assisted living,...
Classification of Illness
The meaning of illness is individualized to each person who experiences an alteration in health. In contrast, disease is a medical term indicating a pathological change in the structure and function of the body or mind. It is a condition that has specific symptoms and boundaries.
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe and...
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe and...
Nephrotic Syndrome III : Nursing Management
Nursing management for nephrotic syndrome adapts as the disease progresses, with strategies evolving to address advancing symptoms and complications.Early-Stage Management In the early stages, nursing interventions for nephrotic syndrome resemble those used in managing acute glomerulonephritis, focusing on symptom monitoring, fluid balance, and managing mild to moderate edema.Vital Signs: Regularly monitor blood pressure, pulse, respiratory rate, and temperature to promptly identify...
Kidney Transplant I: Introduction
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
Kidney Transplant III: Nursing Management
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...


