在接受手术的退伍军人中,终身护理和满意度的趋势
Shukri H A Dualeh1,2, Maia S Anderson1,2, Paul Abrahamse3
1Department of Surgery, University of Michigan, Ann Arbor, MI.
Annals of surgery
|February 23, 2024
概括
终身护理服务,包括息护理和临终关怀,在接受手术的退伍军人中显著增加. 家庭对护理的满意度也有所提高,尽管医院的差异仍然存在.
科学领域:
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
- 抚慰性护理是一种缓解性护理.
背景情况:
- 退伍军人健康管理局 (VA) 实施了全系统的变化,以加强终身护理.
- 这些变革对EOL服务使用率和家庭满意度的影响在很大程度上尚未得到研究.
研究的目的:
- 分析退伍军人住院后手术服务和退伍军人家庭满意度的趋势.
- 确定与VA系统内EOL护理交付和结果变化相关的因素.
主要方法:
- 对155,250名退伍军人进行回顾性分析,这些退伍军人在住院手术后90天内死亡 (2010-2019).
- 利用VA丧亲家庭调查 (BFS) 来评估息治疗,住院使用和满意度.
- 在对医院级因素进行风险和可靠性调整后,采用多变量线性回归.
主要成果:
- 息治疗咨询和住院使用率增加了一倍以上 (28.1%至61.1%,18.9%至46.9%).
- 在BFS的优秀整体护理得分从56.1%增加到64.7%.
- 农村位置和ACGME认证与护理的最大改进有关.
结论:
- 退伍军人EOL护理满意度的改善与增加使用息和临终关怀服务相关.
- 在医疗改善方面,医院间显著的变化需要进一步研究可操作的医院级特征.
- 需要有针对性的干预措施来减少异质性,并在所有VA设施中加强EOL护理.
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