晚期癌症的偏好和实际死亡地点:前性纵向研究
Talita Caroline de Oliveira Valentino1, Carlos Eduardo Paiva1,2, Marco Antonio de Oliveira1
1GPQual - Research Group on Palliative Care and Quality of Life, Barretos Cancer Hospital, Barretos, São Paulo, Brazil.
BMJ supportive & palliative care
|July 4, 2023
概括
晚期癌症患者的首选死亡地点因临床情景而异. 实际死亡地点往往与偏好不同,突出了对灵活的终身护理计划的需求.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 在瘤学瘤学.
- 老年病的医生 老年病的医生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 了解患者首选死亡地点 (PPoD) 对于将终身护理与患者价值观保持一致至关重要.
- 晚期癌症患者的偏好可能会根据不断变化的临床情况和症状负担而改变.
研究的目的:
- 评估不同生命终结场景中晚期癌症患者的首选死亡地点 (PPoD).
- 为了确定患者的PPoD与其实际死亡地点之间的一致性.
主要方法:
- 一项前性队列研究,涉及190名晚期癌症患者和护理人员.
- 在12个月内,每3个月进行一次采访,以在四个不同的临床场景下收集PPoD数据.
- 对PPoD转移的分析和与实际死亡地点的协议.
主要成果:
- 在涉及一般恶化或家庭访问的场景中,家庭是最常见的PPoD.
- 在出现严重症状的情景中,喜欢放松护理单位 (PCU) 和医院.
- 事实上,死亡地点与上一次声明的偏好一致率为51.0% (k=0.252).
- 农村生活,不良的自我健康感知和疼痛与在偏好的地方死亡有关.
结论:
- 当在特定的临床背景下呈现时,家庭死亡并不是普遍首选的.
- 首选和实际的死亡地点受到患者的临床情况和症状严重程度的重大影响.
- 终身护理规划需要对考虑临床发展轨迹的偏好进行动态评估.
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