医疗服务的住院病人的死亡:综合癌症中心的特点
Sebastiano Mercadante1, Alessio Lo Cascio2, Alessandra Casuccio3
1Pain Relief and Supportive Care, Casa di Cura La Maddalena, Palermo, Italy 03sebelle@gmail.com.
BMJ supportive & palliative care
|March 7, 2024
概括
生活结束时的护理强度在不同的医院环境中有很大差异. 血液学部门提供了更积极的治疗方法,而息护理部门则专注于对垂死癌症患者的症状管理.
科学领域:
- 在瘤学瘤学.
- 抚慰性护理是一种缓解性护理.
- 医学伦理 医学伦理
背景情况:
- 终身护理的强度在医疗机构之间有所不同.
- 了解这些变异对于优化综合癌症中心的患者护理至关重要.
研究的目的:
- 为了比较一个综合性癌症中心内的不同单位在生命的最后三天提供护理的强度.
主要方法:
- 在2019年7月至2023年6月期间死亡的177名患者的回顾性图表审查.
- 收集的数据包括人口统计,诊断和干预措施,如药物,呼吸辅助,输血和诊断测试.
- 分析集中在三个部门:急性息治疗 (APCU),瘤学 (ONC) 和血液学 (HEM),包括其移植部门.
主要成果:
- 血液病学部门 (HEM) 显示,生命维持治疗的利用率更高,包括血管活性药物,抗生素,输血,成像和呼吸系统支持.
- 急性息护理单位 (APCU) 的特点是更频繁地使用阿片类药物和镇静剂来治疗症状.
- 瘤科 (ONC) 显示抗凝剂和呼吸系统支持的使用增加.
结论:
- 基于医疗环境 (HEM,ONC,APCU) 的终身护理强度存在显著差异.
- 与息治疗单位相比,血液病科单位采用更积极的,维持生命的干预措施.
- 生命末期的护理决策应与短期预后和患者的期望保持一致,避免不成比例的治疗.
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