入院したムスリム患者の終末期の経路:ICU,ICU後,病棟での積極的なケアから快適に集中するケアへの進化
Imran Khalid1,2, Manahil Imran1, Raafey Imran1
1Department of Critical Care, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia.
The American journal of hospice & palliative care
|August 30, 2025
まとめ
イスラム教徒の患者は しばしば生命の終わりの時に 積極的なケアを受けます この研究では,病棟での死亡が緩和ケアと以前の議論に関連しており,ICUでの死亡はより生命維持治療を伴うことが判明し,文化的に敏感な終末期ケア計画の必要性を強調した.
科学分野:
- 医学 の 倫理
- 緩和ケア
- 終末期ケアに関する研究
背景:
- 歴史的に見て イスラム教徒の患者は 積極的な終末期ケアを経験し 緩和医療の受け入れが増加しています
- 集中治療室 (ICU) と病棟での死亡に影響を与える要因は不明であり,価値に一致するケアを妨げています.
- これらのパターンを理解することは 文化的に敏感な終末期介護の提供に不可欠です
研究 の 目的:
- イスラム教徒の患者の末期ケアパターンを調査する
- 集中治療室 (ICU) と病棟での死亡の予測要因を特定する.
- 文化的に敏感なケア戦略を イスラム教徒の患者さんに伝えること
主な方法:
- 高等病院での成人ムスリム死亡者 (2021年-2024年) の遡及コホート研究.
- 病棟,ICU,ICU後の病棟による死亡の階層化
- 病棟での死亡率を予測する多変数ロジスティック回帰
主要な成果:
- 1859人のイスラム教徒の死者を分析した. 53%は病棟,39%はICU,8%はICU後の状態.
- 病棟での死亡は,高齢者,併発性患者,がんに関連しており,ICUでの死亡は,急性疾患に関連しています.
- 集中治療室での死亡は生命維持介入 (82%の機械呼吸) が多く,病棟での死亡は緩和ケアへの関与が多くなった (66%).
- DNAR (Do-Not-Attempt-Resuscitation) ステータスは著しく増加したが,しばしば遅かった (88%が死亡).
- 病棟での死亡は,緩和ケア (aOR 15.11),文書化されたコードステータスディスカッション (aOR 4.56) と末期診断に関連しています.
結論:
- イスラム教徒の病棟での死亡は 緩和ケアや 末期診断や 早期DNAR状態と相関しています
- ICUとICU後の死亡は 介護目標の移行を遅らせて 積極的なケアを反映しています
- 高いDNAR採用率 (88%) が遅れていることがあり,早期に文化的に調整されたケア目標に関する議論が必要である.
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