在息性家庭护理中如何定义和量化不良死亡? 使用加拿大interRAI数据进行横截面和探索性研究
Amanda Mofina1, Nicole Williams2, John P Hirdes3
1School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada. amofina@uwaterloo.ca.
BMC palliative care
|March 21, 2025
概括
一项研究确定了社区成年人不良死亡的四个常见指标,包括孤独,抑郁和疼痛. 这些因素相互关联,表明解决其中一个可能会改善其他因素,促进更好的终身体验.
科学领域:
- 老年学是一门学科.
- 抚慰性护理是一种缓解性护理.
- 公共卫生 公共卫生
背景情况:
- 死亡是一个多方面的过程,受到身体,社会,文化,精神,环境和人际关系因素的影响.
- 从历史上看,定性方法主导着对不好的死亡体验的探索.
- 这项研究利用了人口层面的数据来确定不良死亡的关键指标及其预测因素.
研究的目的:
- 在社区生活的成年人中确定不良死亡的关键指标.
- 检查与每个已识别的坏死亡指标相关的预测因素.
- 了解各种不良死亡指标之间的相互关系.
主要方法:
- 从家庭护理居民评估仪器 (RAI-HC) 定期收集的临床和社会人口统计数据进行横截面分析.
- 包括16586名18岁以上的家庭护理客户,他们在2007年4月至2020年3月期间去世.
- 检查四个坏死亡指标:孤独,严重的抑郁症状,严重/痛苦的失控疼痛和严重/痛苦的每日疼痛,使用奇方位分析.
主要成果:
- 33.5%的样本至少经历了一种坏死亡指标.
- 在指标之间发现了显著的相互联系,赔率比 (ORs) 从1.70到3.26.
- 精神病诊断 (OR: 1.29-1.89),家庭/朋友冲突 (OR: 1.21-3.40) 和令人痛苦的社会互动下降 (OR: 2.06-3.70) 是重要的预测因素.
结论:
- 在社区生活的成年人中,四个坏死亡指标普遍存在.
- 这些指标之间存在着相互联系,这表明了对护理的整体方法.
- 早期识别和协作护理规划可以改善生命末期的体验,促进良好的死亡.
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