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The experiences and needs of nurses providing home-based palliative care: A qualitative meta-synthesis. 护士提供家庭姑息治疗的经验和需求:定性荟萃综合。
IF 1.7 4区 医学 Q2 Medicine Pub Date : 2023-10-01 Epub Date: 2022-05-31 DOI: 10.1177/08258597221105167
Yu-Hsuan Wu, Hui-Ya Hsieh, Yu-Ling Kuo, Chien-Yi Wu

Objective(s): We conducted a qualitative meta-synthesis of qualitative studies on nurses' experiences when caring for palliative patients to (1) identify the needs of nurses and (2) describe their experiences to provide more in-depth information. Methods: Qualitative articles published in English from 2000 to 2022 were identified from several databases through a searching strategy. Authors screened through the title, abstract, and full text of relevant studies. Articles were read repeatedly and discussed. The thematic analysis methodology was adopted to analyze the data. Results: Of 967 articles, 22 were included in our review. Notions reflecting community nurses providing palliative home care were clustered into four themes: (1) nature of community-based palliative nursing, (2) teamwork, (3) relationship with patient and family, and (4) resources. Findings also suggest establishing a sound support system, strengthening palliative education, and creating more decisive referral criteria and systems. Conclusions: The growing need for palliative home care has become challenging for community health care systems. Our study summarized various aspects of nurses providing home-based palliative care. The findings provide information for health care and education settings to improve home care systems and recruit more staff to meet the needs.

目的:我们对护士在照顾姑息性患者时的经验进行了定性荟萃分析,以(1)确定护士的需求,(2)描述他们的经验,提供更深入的信息。方法:采用检索策略,从多个数据库中检索2000年至2022年发表的英文定性文章。作者筛选了相关研究的标题、摘要和全文。文章被反复阅读和讨论。采用专题分析方法对数据进行分析。结果:967篇文章中,22篇被纳入我们的综述。反映社区护士提供姑息性家庭护理的概念分为四个主题:(1)社区姑息性护理的性质,(2)团队合作,(3)与患者和家人的关系,以及(4)资源。调查结果还建议建立一个健全的支持系统,加强姑息治疗教育,并建立更果断的转诊标准和系统。结论:对姑息性家庭护理日益增长的需求对社区卫生保健系统来说已成为一项挑战。我们的研究总结了护士提供家庭姑息治疗的各个方面。研究结果为医疗保健和教育环境提供了信息,以改善家庭护理系统并招聘更多员工来满足需求。
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引用次数: 3
Is Low Volume Drainage of Ascites Associated With Improved Survival in Digestive System Cancer Patients With Malignant Ascites?-A Retrospective Cohort Study. 癌症恶性腹水患者低容量腹水引流与提高生存率有关吗-一项回顾性队列研究。
IF 1.7 4区 医学 Q2 Medicine Pub Date : 2023-10-01 Epub Date: 2023-04-24 DOI: 10.1177/08258597231170049
Shunya Hoshino, Yusuke Takagi, Takeo Fukagawa, Keiji Sano, Nobuhiko Seki, Yojiro Hashiguchi, Etsuko Aruga

Objectives: To determine whether the volume of paracentesis for malignant ascites in acute care hospital wards is associated with survival and symptom relief. Methods: Patients with malignant ascites caused by digestive system cancer who underwent paracentesis between January 2010 and April 2022 were retrospectively analyzed from medical records. Collected data included the drainage volume per paracentesis procedure, survival time from the first paracentesis procedure, symptoms, and adverse events. According to the volume per paracentesis procedure, we divided the patients into the "small-drainage" (≤1500 mL) and "standard-drainage" (>1500 mL) groups. Results: The median age of the 144 patients was 69 years, 33% were female, and 64% had gastrointestinal cancer. The median survival from the first paracentesis procedure was 36 days. Eighty-nine (61.8%) and 55 (38.2%) patients were allocated to the small-drainage and standard-drainage groups, respectively. The median number of paracentesis procedures in the small-drainage and standard-drainage groups was 12 and 7, respectively (P=.001). The median survival in the small-drainage and standard-drainage groups was 50 and 44 days, respectively (P=.76). The multivariate analysis showed that the amount of drainage per session was not significantly associated with survival. Symptoms improved similarly in the 2 groups. No serious adverse events were observed. Conclusions: Paracentesis was demonstrated to be effective and safe, irrespective of the amount of fluid drained, for patients with malignant ascites in an acute care hospital. Thus, a strategy of limiting the amount of drainage is not associated with longer survival.

目的:确定急性护理医院病房恶性腹水的穿刺量是否与生存率和症状缓解有关。方法:回顾性分析2010年1月至2022年4月期间癌症消化系统恶性腹水患者行穿刺置管术的病历资料。收集的数据包括每次穿刺的引流量、第一次穿刺的存活时间、症状和不良事件。根据每次穿刺的体积,我们将患者分为“小引流”(≤1500 mL)和“标准排水”(>1500 mL)组。结果:144例患者的中位年龄为69岁,33%为女性,64%为胃肠道癌症。第一次穿刺的中位生存期为36天。89名(61.8%)和55名(38.2%)患者分别被分配到小型引流组和标准引流组。小引流组和标准引流组穿刺术的中位次数分别为12次和7次(P=0.001)。小引流组的中位生存期和标准引流组织的中位存活期分别为50天和44天(P=.76)。多变量分析显示,每次穿刺的引流量与生存期无显著相关性。两组的症状改善情况相似。未观察到严重不良事件。结论:在急性护理医院,无论排出多少液体,穿刺对恶性腹水患者都是有效和安全的。因此,限制排水量的策略与更长的生存期无关。
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引用次数: 0
Determinants of Cancer-Related Fatigue among Cancer Patients: A Systematic Review. 癌症患者癌症相关疲劳的决定因素:系统综述。
IF 1.7 4区 医学 Q2 Medicine Pub Date : 2023-10-01 Epub Date: 2022-10-17 DOI: 10.1177/08258597221131133
Fatima DSilva, Pritanjali Singh, Athar Javeth

Objectives: This systematic review aims to assess and explore various determinants of cancer- related fatigue. Methods: A systematic search of various determinants of Cancer-related fatigue (CRF) was performed in different databases like PubMed, Google Scholar, Science Direct and Clinical Key dating from 1990 to September 2020. Results: A total of 6115 studies were screened and 95 articles related to determinants of fatigue were retained. Various modifiable and non-modifiable determinants including socio-demographic, clinical, treatment related, plasma biomarker related, genetic, behavioural, concurrent symptoms related and psychological determinants were identified. Depression was one of the significant factors reported in 28% of studies, followed by pain, (17%), performance status (16%), chemotherapy and anxiety (15%). Conclusion: It is recommended that nurses and clinicians should anticipate, identify and take appropriate interventions to manage those modifiable factors. Ultimately, managing the modifiable factors helps in the comprehensive care of cancer patients.

目的:本系统综述旨在评估和探讨癌症相关疲劳的各种决定因素。方法:从1990年到2020年9月,在PubMed、Google Scholar、Science Direct和Clinical Key等不同数据库中对癌症相关疲劳(CRF)的各种决定因素进行了系统搜索。结果:共筛选了6115项研究,保留了95篇与疲劳决定因素相关的文章。确定了各种可改变和不可改变的决定因素,包括社会人口学、临床、治疗相关、血浆生物标志物相关、遗传、行为、并发症状相关和心理决定因素。在28%的研究中,抑郁是重要因素之一,其次是疼痛(17%)、表现状态(16%)、化疗和焦虑(15%)。结论:建议护士和临床医生预测、识别并采取适当的干预措施来管理这些可改变的因素。最终,管理可改变的因素有助于癌症患者的全面护理。
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引用次数: 4
Food as Love: Ethical and Moral Dilemmas in Withdrawal of Artificial Nutrition and Hydration in the Minimally Conscious State. 食物如爱:在最低意识状态下退出人工营养和补水的伦理和道德困境。
IF 1.7 4区 医学 Q2 Medicine Pub Date : 2023-10-01 Epub Date: 2021-05-03 DOI: 10.1177/08258597211014359
Kelley Finch Newcomer, Robert L Fine, Antoinette Fidelia Newman

Supportive Palliative Care and Hospice professionals frequently attend to Minimally Conscious State (MCS) patients near the end of life and in so doing, face decisions over maintenance or withdrawal of artificial nutrition and hydration. Although both withholding and withdrawal of artificial nutrition and hydration (ANH) in such circumstances are considered by experts in ethics and law to be acceptable, not all families nor health care professionals agree. This paper will explore basic aspects of serious brain injuries, especially MCS, the psychological role of food in interpersonal relationships, and lessons from clinical ethics that can help in goals of care discussions about withdrawal of ANH.

支持性姑息治疗和临终关怀专业人员经常在生命即将结束时照顾最低意识状态(MCS)患者,在这样做的过程中,他们面临着维持或停止人工营养和水合作用的决定。尽管伦理和法律专家认为在这种情况下拒绝和停止使用人工营养和水合作用是可以接受的,但并非所有家庭和医疗保健专业人员都同意这一点。本文将探讨严重脑损伤的基本方面,特别是MCS,食物在人际关系中的心理作用,以及临床伦理学的经验教训,这些经验教训有助于关于ANH戒断的护理目标讨论。
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引用次数: 1
Patients' Experiences of Cancer Pain: A Descriptive Qualitative Study. 癌症疼痛患者体验的描述性定性研究。
IF 1.7 4区 医学 Q2 Medicine Pub Date : 2023-10-01 Epub Date: 2023-01-02 DOI: 10.1177/08258597221149545
Hadi Hassankhani, Mohammad Hajaghazadeh, Samira Orujlu

Objective: The aim of this study was to explore the cancer pain experiences of Iranian patients.

Design: A qualitative descriptive design was used.

Methods: This qualitative descriptive study was performed on 17 participants between December 2020 and September 2021. Data were collected using semistructured interviews and analyzed by Graneheim and Lundman's content analysis method.

Results: Three main categories emerged in relation to patients' experiences of cancer pain. Categories included (1) characteristics of cancer pain, (2) pain self-management strategies, and (3) influence of pain on patient and her/his family.

Conclusions: Most patients believe that pain is God's will, and family members, doctors, and nurses can assist patients cope with pain by respecting this belief and supporting spiritual healing. Strengthening pain management strategies, expanding social networks, and convincing the patients that they are not an interruption to their families can all help patients maintain their fighting spirit and pain tolerance. To provide holistic care, healthcare providers, particularly nurses, should consider the physical, sociocultural, and spiritual aspects of cancer pain.

目的:探讨伊朗癌症患者的疼痛体验。设计:采用定性描述性设计。方法:这项定性描述性研究于2020年12月至2021年9月对17名参与者进行。数据采用半结构化访谈收集,并采用Graneheim和Lundman的内容分析方法进行分析。结果:与癌症患者疼痛经历相关的三个主要类别出现。分类包括(1)癌症疼痛的特征,(2)疼痛自我管理策略,以及(3)疼痛对患者及其家人的影响。结论:大多数患者相信疼痛是上帝的旨意,家庭成员、医生和护士可以通过尊重这一信念和支持精神治疗来帮助患者应对疼痛。加强疼痛管理策略,扩大社交网络,让患者相信他们不会打扰家人,这些都可以帮助患者保持战斗精神和疼痛耐受力。为了提供全面的护理,医疗保健提供者,特别是护士,应该考虑癌症疼痛的身体、社会文化和精神方面。
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引用次数: 0
Effect of Auricular Acupressure in Management of Constipation in Palliative Care Patients. 耳穴按压治疗姑息治疗患者便秘的效果。
IF 1.7 4区 医学 Q2 Medicine Pub Date : 2023-09-06 DOI: 10.1177/08258597231181040
Derya Biçak Ayik, Gülbeyaz Can

Objectives: This experimental randomized-controlled study was performed to define the efficacy of auricular acupressure (AA) in the management of constipation developing in palliative care patients. Methods: According to the pre-prepared randomization list, 44 patients were included in the experimental group and 46 patients were included in the control group. Routine clinical treatment and care implementation were maintained in the patients in both groups. AA was performed for 4 weeks in patients in the experimental group. During the study, to determine the complaints of the patients regarding constipation, the information in the daily patient chart was examined at least 5 times by interviewing with the patient/patient's relative in the clinic and/or via phone call, and the results were recorded in the patient chart and data collection forms. The independent variable of the study is AA application, and the dependent variables are constipation and quality of life. Results: It was determined that there was no statistically significant difference between the daily defecation frequency of the 2 groups during the first 11 days. However, after the 12th day, the daily stool frequency of the experimental group was higher compared to the control group and this difference obtained between the 2 groups was statistically significantly different. AA was effective in decreasing laxative use. Conclusion: This intervention increased stool frequency, reduced physical and psychosocial symptoms, anxieties, and improved stool satisfaction and it was an effective approach to improving the quality of life. It is recommended that the daily use of AA should be evaluated. The healthcare providers including nurses, patients, and patient relatives should be trained regarding AA.

目的:本实验随机对照研究旨在确定耳穴按压(AA)治疗姑息治疗患者便秘的疗效。方法:根据事先编制的随机分组表,将44例患者纳入实验组,46例患者纳入对照组。两组患者均维持常规临床治疗和护理执行。实验组患者AA治疗4周。在研究过程中,为了确定患者对便秘的抱怨,通过门诊与患者/患者亲属面谈和/或通过电话对每日患者表格中的信息进行至少5次检查,并将结果记录在患者表格和数据收集表中。本研究的自变量为AA应用,因变量为便秘和生活质量。结果:测定两组患者前11天每日排便次数比较,差异无统计学意义。但在第12天后,试验组的日大便频率高于对照组,两组间的差异有统计学意义。AA能有效减少泻药的使用。结论:这种干预增加了排便频率,减少了身体和心理社会症状、焦虑,提高了排便满意度,是改善生活质量的有效方法。建议对AA的每日用量进行评估。医疗保健提供者(包括护士、患者和患者家属)应接受有关AA的培训。
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引用次数: 0
Chinese Diaspora Communities' Knowledge of and Engagement with Advance Care Planning: A Systematic Integrative Review. 华人社区对预先护理计划的了解和参与:一项系统的综合评价。
IF 1.7 4区 医学 Q2 Medicine Pub Date : 2023-07-01 DOI: 10.1177/08258597231158321
Zhuangshuang Li, Esther Ruth Beck, Sonja McIlfatrick, Felicity Hasson

Objectives: To synthesize evidence regarding Chinese diasporas' understanding, experience, and factors influencing engagement with advance care planning. Methods: A systematic integrative review using content analysis. Seven electronic databases (Embase, CINAHL, SCOPUS, Web of Science, Medline (OVID), PsycINFo, and The Cochrane Library) and gray resources were searched for studies from January 1990 to March 2022. Study quality appraisal was undertaken. Results: 27 articles were identified and rated as moderate to good. Two overarching and interrelated themes were identified, "Awareness and knowledge" and "Engagement with advance care planning." There are low levels of awareness, knowledge and engagement with advance care planning for Chinese diaspora. Findings highlight that this is influenced by two key factors. First, the geographic context and legal, cultural, and social systems within which the Chinese diasporas are living act as a potential catalyst to enhance awareness and engagement with advance care planning. Second, aspects of Chinese diasporas' original culture, such as filial piety and a taboo surrounding death, were reported to negatively affect the promotion and engagement of advance care planning. Significance of Results: Chinese diasporas are intermediaries between two divergent cultures that intertwine to strongly influence engagement with advance care planning. Hence, a bespoke culturally tailored approach should be accommodated in future research and practice for Chinese communities in multicultural countries to further advance palliative and end-of-life care awareness among this group.

目的:综合有关中国侨民对预先护理计划的理解、经验和影响因素的证据。方法:采用内容分析法进行系统综合评价。检索了7个电子数据库(Embase、CINAHL、SCOPUS、Web of Science、Medline (OVID)、PsycINFo和Cochrane Library)和灰色资源,检索了1990年1月至2022年3月的研究。进行研究质量评价。结果:27篇文章被确定,并被评为中度至良好。确定了两个总体和相互关联的主题,“意识和知识”和“参与预先护理计划”。对海外华人的预先护理计划的认识、知识和参与程度都很低。研究结果强调,这受到两个关键因素的影响。首先,中国侨民所处的地理环境、法律、文化和社会制度是提高对预先护理计划的认识和参与的潜在催化剂。其次,据报道,中国侨民的原始文化方面,如孝道和对死亡的禁忌,对提前护理计划的促进和参与产生了负面影响。结果的意义:中国散居者是两种不同文化之间的中介,这两种文化相互交织,强烈地影响着预先护理计划的参与。因此,在未来的研究和实践中,应针对多元文化国家的华人社区采取一种量身定制的文化方法,以进一步提高这一群体的姑息治疗和临终关怀意识。
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引用次数: 3
Challenges Experienced by Nurses in Providing Pediatric Palliative Care: An Interpretive Phenomenological Analysis. 护士在提供儿科姑息治疗时所遇到的挑战:一项解释性现象学分析。
IF 1.7 4区 医学 Q2 Medicine Pub Date : 2023-07-01 DOI: 10.1177/08258597231173313
Erna Judith Roach, Omar Al Omari, Sheeba Elizabeth John, Frincy Francis, Judie Arulappan, Lina Shakman, Aysha Al Hashmi, Sulaiman Al Sabei, Atika Khalaf

Objectives: Pediatric leukemia is the most common cancer among children younger than 14 years of age. Children with leukemia require palliative care as additional support from the health care team. Providing palliative care to children is challenging. Thus, this study explored the challenges experienced by nurses in providing pediatric palliative care to children with leukemia. Methods: Semi-structured face-to-face interviews were conducted on a purposive sample of 11 nurses in the hematology-oncology units of a tertiary care hospital in Oman. Results: Interviews were transcribed and analyzed using interpretive phenomenological analysis, which revealed three main themes and seven subthemes related to challenges in providing pediatric palliative care: Personal challenges: Nurses were unable to neutralize their emotions, which burdened them emotionally; due to multitasking, nurses were unable to manage their tasks within the expected time frame; nurses were stressful when they participated in explaining the diagnosis to the parents; and nurses felt powerless when the health condition of some children deteriorated. Educational challenges: Nurses felt unprepared to meet the physical/psychosocial aspects of caring for children with leukemia. Organizational challenges: Nurses stated that families and nurses required rooms to pray, rest, and read Quran, and they needed a private place to speak to families; and nurses mentioned that there are limited number of psychologists to meet the psychological and social needs of children and their families. Conclusion: Prioritizing and implementing strategies for a supportive workplace, guided clinical practice, and maximizing nurses' satisfaction are crucial.

目的:儿童白血病是14岁以下儿童最常见的癌症。患有白血病的儿童需要姑息治疗作为卫生保健小组的额外支持。向儿童提供姑息治疗具有挑战性。因此,本研究探讨护士在为白血病儿童提供小儿姑息治疗时所遇到的挑战。方法:对阿曼一家三级医院血液肿瘤科的11名护士进行了半结构化的面对面访谈。结果:对访谈进行转录和解释现象学分析,揭示了与提供儿科姑息治疗挑战相关的三个主题和七个副主题:个人挑战:护士无法中和自己的情绪,这给他们带来了情感负担;由于多任务处理,护士无法在预期的时间框架内管理他们的任务;护士在参与向家长解释诊断结果时压力较大;当一些儿童的健康状况恶化时,护士感到无能为力。教育方面的挑战:护士对照顾白血病儿童的生理/心理方面感到措手不及。组织挑战:护士表示,家属和护士需要房间来祈祷、休息和阅读《古兰经》,她们需要一个私人的地方与家属交谈;护士们提到,满足儿童及其家庭心理和社会需求的心理学家数量有限。结论:优先考虑和实施支持性工作场所策略,指导临床实践,最大限度地提高护士满意度至关重要。
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引用次数: 0
"There is No Communication": A Qualitative Examination of Deaf Signers' Experiences With Advance Care Planning. “没有沟通”:聋人手语者预先照护计划经验的质性检验。
IF 1.7 4区 医学 Q2 Medicine Pub Date : 2023-07-01 DOI: 10.1177/08258597231179763
Caroline Cerilli, Gabrielle Katz, Angelo E Volandes, Aretha Delight Davis, Michael K Paasche-Orlow, Tyler G James, Michael M McKee

Objective(s): Deaf American Sign Language (ASL) users are subject to health care disparities resulting from communication and language barriers. Currently, few resources on advance care planning and end-of-life care exist in ASL. This study explores Deaf ASL users' perceptions and experiences with end-of-life care and advance care planning. Methods: Semi-structured 1:1 interviews with Deaf signers were translated, and transcribed into English by a bilingual researcher. Investigators inductively coded transcripts and identified themes of barriers, facilitators, knowledge, and sources of information regarding end-of-life care. Participants' knowledge of advance care planning and completion of advance care planning documents were evaluated using a brief assessment. Results: Eleven Deaf ASL users participated in the study with two deaf interviewers. Participants reported barriers to end-of-life care including poor provider communication, inaccessible sources, and inadequate provision of accommodations, leading to patient distrust. Participants' understanding of advance care planning was facilitated by accessible forms of communication and their social networks, such as family, friends, and Deaf peers. Participants primarily gained information on end-of-life care from first-hand familial experience, peers, and media. Participants' mean advance care planning knowledge was 4.6 out of 15 (SD  =  2.6). Conclusions: Deaf ASL users face scarce accessible resources around end-of-life care, lowering their ability to understand and proceed with advance care planning. Implementation of ASL accessible advance care planning educational tools in health care settings is needed.

目的:美国聋人手语(ASL)使用者由于沟通和语言障碍而受到医疗保健差异的影响。目前,关于美国手语的预先护理计划和临终关怀的资源很少。本研究探讨聋人美国手语使用者对临终照护及事前照护计划的认知与经验。方法:由双语研究者对聋哑人进行半结构化的1:1访谈,并将其翻译成英文。研究者归纳编码转录本和确定主题的障碍,促进因素,知识,以及有关临终关怀的信息来源。参与者的知识提前护理计划和完成提前护理计划文件进行了评估,使用简短的评估。结果:11名聋人美国手语使用者与2名聋人访谈者参与了本研究。参与者报告了临终关怀的障碍,包括提供者沟通不畅,无法获得资源和住宿供应不足,导致患者不信任。通过无障碍的交流形式和他们的社会网络,如家庭、朋友和聋人同伴,促进了参与者对预先护理计划的理解。参与者主要从第一手的家庭经验、同伴和媒体中获得关于临终关怀的信息。参与者的平均提前护理计划知识为4.6 / 15 (SD = 2.6)。结论:聋人美国手语使用者在临终关怀方面缺乏可获得的资源,降低了他们理解和进行预先护理计划的能力。需要在卫生保健机构中实施无障碍的美国手语预先护理计划教育工具。
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引用次数: 0
Symptom Management and Support in Dying Patients with Cancer and Coronavirus Disease-19-A Register-Based Study. 癌症和冠状病毒病-19死亡患者的症状管理和支持——基于注册的研究。
IF 1.7 4区 医学 Q2 Medicine Pub Date : 2023-07-01 Epub Date: 2023-02-15 DOI: 10.1177/08258597231157622
Christel Hedman, Peter Strang, Staffan Lundström, Lisa Martinsson

Objective: Little is known to what extent access to specialist palliative care (SPC) for cancer patients dying with coronavirus disease-2019 (COVID-19) affects the occurrence of breakthrough symptoms, symptom relief, and overall care, compared to hospital deaths. Our aim was to include patients with both COVID-19 and cancer and compare those dying in hospitals with those dying in SPC with reference to the quality of end-of-life care.

Methods: Patients with both cancer and COVID-19 who died in hospitals (n = 430) and within SPC (n = 384) were identified from the Swedish Register of Palliative Care. The hospital and SPC groups were compared regarding the quality of end-of-life care, including the occurrence of 6 breakthrough symptoms during the last week in life, symptom relief, end-of-life care decisions, information, support, and human presence at death.

Results: Breakthrough of breathlessness was more common in the hospital patients compared to the SPC patients (61% and 39%, respectively; p < .001), while pain was less common (65% and 78%, respectively; p < .001). Breakthrough of nausea, anxiety, respiratory secretions, or confusion did not differ. All 6 symptoms, except for confusion, were more often completely relieved in SPC (p = .014 to p < .001 in different comparisons). In SPC, a documented decision about the goal being end-of-life care and information about this were more common than in hospitals (p < .001). Also, to have family members present at the time of death and for family members to be offered a follow-up talk afterward was more common in SPC (p < .001).

Conclusion: More systematic palliative care routines may be an important factor for better symptom control and higher quality of end-of-life care in hospitals.

目的:与医院死亡相比,尚不清楚癌症冠状病毒病2019(新冠肺炎)患者获得专科姑息治疗(SPC)在多大程度上影响突破性症状的发生、症状缓解和整体护理。我们的目标是将新冠肺炎和癌症患者包括在内,并根据临终关怀的质量将在医院死亡的患者与在SPC死亡的患者进行比较。方法:癌症和新冠肺炎患者在医院死亡(n = 430)和SPC(n = 384)从瑞典姑息治疗注册处鉴定。比较了医院组和SPC组的临终关怀质量,包括生命最后一周出现的6种突破性症状、症状缓解、临终关怀决策、信息、支持和死亡时的人类存在。结果:与SPC患者相比,医院患者呼吸困难的突破更常见(分别为61%和39%;p p p = .014至p p p 结论:更系统的姑息治疗程序可能是更好地控制症状和提高医院临终关怀质量的重要因素。
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Journal of Palliative Care
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