根据死亡原因使用临终关怀:使用犹他州人口数据库的队列研究
Rebecca L Utz1,2,3,4, Michael Hollingshaus5, Attrayee Bandyopadhyay1
1Department of Sociology, College of Social & Behavioral Sciences, University of Utah, Salt Lake City, Utah, USA.
The American journal of hospice & palliative care
|April 29, 2025
概括
临终关怀模式因死亡原因而有很大差异. 非癌症患者,特别是中风,痴呆症和慢性肺炎患者,经常经历不理想的临终关怀使用,突出需要灵活的终身护理模式.
科学领域:
- 老年学是指老年学的学科.
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 临终关怀,最初是针对预后<6个月的癌症患者,现在用于各种限制生命的疾病.
- 像癌症这样的疾病有可预测的下降,而阿尔茨海默病和相关痴呆症 (ADRD) 和慢性阻塞性肺部疾病 (COPD) 呈现长期的下降.
- 当前的宿舍资格和实践可能无法最佳地服务于所有生命终端 (EOL) 轨迹.
研究的目的:
- 为了确定宿舍利用率是否根据死亡的根本原因而有所不同.
- 评估现有的临终关怀模式是否为所有诊断提供最佳的EOL护理.
- 在各种死亡原因中识别临终关怀使用模式.
主要方法:
- 来自犹他州人口数据库 (UPDB) 护理人员人口科学 (C-PopS) 已故队列的17321名临终关怀用户的分析.
- 多项回归分析以模拟根据死亡原因的临终关怀住院时间.
- 卡普兰-梅尔生存曲线用于可视化宿舍使用模式.
主要成果:
- 非癌症死者更容易出现不理想的临终关怀使用:"最小使用" (<1周) 或"延长使用" (>6个月).
- 卒中死者显示"最小使用"临终关怀模式的可能性最高.
- 痴呆症和COPD死者最有可能经历"延长使用"临终关怀模式.
结论:
- 根据死亡原因,宿舍护理模式存在显著的差异.
- 当前的临终关怀框架可能无法充分满足非癌症诊断和长期EOL轨迹的患者的需求.
- 开发灵活的,类似临终关怀的EOL护理模式对于满足各种患者需求和不同的EOL轨迹至关重要.
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