估计安宁疗护对关键病人-家庭疗护结果的影响,使用美国全国的概率样本。

John G Cagle, Peiyuan Zhang, Sarah Clem
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引用次数: 0

摘要

临终关怀被吹捧为临终关怀的典范。然而,在国家层面上,很少有可概括的证据来评估安宁疗护的好处。我们使用基于全国人口的美国成年人概率样本(数据收集于2015年春夏),采用六个逻辑回归模型来评估临终关怀参与与临终结果(疼痛、家庭死亡、家人在场、获得延长生命的护理、对精神/宗教信仰的尊重、经济负担)之间的联系,这些数据来自N = 235名死者生前的非正式照护者。受访者年龄为M = 55岁(SD = 17), 55%为女性,77%为白人,91%为非西班牙裔,71%曾照顾过临终关怀接受者。在完全调整后的分析中,安宁疗护使用者在两个模型中观察到较好的结果:(a)死亡时家人/朋友的存在(OR = 2.82, SE = 0.48, P < 0.05)和(b)对精神/宗教信仰的尊重(OR = 9.52, SE = 0.73, P < 0.01)。其他调整后的模型中,安宁疗护使用率差异无统计学意义(P > 0.05)。虽然还需要更多的研究,但研究结果支持了临终关怀仍然是美国临终关怀的高质量选择的说法
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Estimating the Impact of Hospice Care on Key Patient-Family Care Outcomes Using a Nationwide U.S. Probability Sample.

Hospice is touted as an exemplary model for end-of-life care. However, there is little generalizable evidence estimating benefits of hospice at the national level. Using a national population-based probability sample of U.S. adults with weights applied (data collected Spring/Summer 2015), we conducted six logistic regression models to evaluate linkages between hospice involvement and end-of-life outcomes (pain, home death, presence of family, access to life-prolonging care, respect for spiritual/religious beliefs, financial burden) from N = 235 informal caregivers of decedents prior to death. Respondents were M = 55 years old (SD = 17), 55% female, 77% White, 91% non-Hispanic, and 71% had cared for a hospice recipient. In fully adjusted analyses, hospice users had better reported outcomes observed in two models: (a.) presence of family/friends at death (OR = 2.82, SE = .48, P < .05), and (b.) respect for spiritual/religious beliefs (OR = 9.52, SE = .73, P < .01). Hospice utilization was not statistically significant (P > .05) in all other adjusted models. Although more research is needed, findings support claims that hospice remains a high quality option for end-of-life care in the U.S.

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