影响癌症病人及主要照护者居家临终照护的社会因素。

IF 2.8 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Supportive Care in Cancer Pub Date : 2024-12-26 DOI:10.1007/s00520-024-09074-1
Shuji Hiramoto, Ryu Hashimoto, Tatsuya Morita, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Kento Masukawa, Mitsunori Miyashita, Masahito Hitosugi
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引用次数: 0

摘要

目的:本研究旨在探讨患者及照护者对居家临终关怀意愿的社会因素,包括影响其实现的相关因素。方法:采用《丧亲照护者安宁与姑息疗护品质评价研究(J-HOPE 4)》的问卷调查数据集(居家临终关怀N = 625,医院临终关怀N = 7603)进行二次分析,并采用多元分析(多元逻辑回归),探讨患者及照护者社会因素对居家临终关怀履行的影响。解释变量包括患者年龄、性别等11个社会因素和主要照顾者的18个社会因素。结果:医疗费用低于900美元(OR, 2.05)、年收入低于3.6万美元(OR, 0.669)、偏好居家护理(OR, 1.49)、偏好在家离世(OR, 1.58)、希望在家离世(OR, 1.52)和患者经济状况不佳(OR, 0.72)是患者选择居家临终护理的显著因素。与照顾者相关的显著因素包括男性照顾者(OR 0.66)、精神状态差(OR 0.79)、提供日常照顾的能力(OR 3.02)、照顾已故家庭成员的经历(OR 0.66)、是否存在替代照顾者(OR 0.78)以及与照顾者同居(OR 1.47)。结论:患者偏好、社会情境、主要照护者的社会情境和心理状态影响居家临终关怀。
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Social factors affecting home-based end-of-life care for patients with cancer and primary caregivers.

Objective: This study aimed to explore the social factors of patients and caregivers, including those related to their wishes for home-based end-of-life care that influence its fulfillment.

Methods: A secondary analysis was conducted using the dataset (home-based end-of-life care N = 625, hospital end-of-life care N = 7603) Comprehensive patient-based survey conducted by The Study on Quality Evaluation of Hospice and Palliative Care by Bereaved Caregivers (J-HOPE 4) and multivariate analysis (multiple logistic regression) to explore the impact of social factors of patients and caregivers on the fulfillment of home-based end-of-life care. The explanatory variables included 11 social factors of patients, such as age and sex, and 18 social factors of primary caregivers.

Results: For patients with medical expenses less than 900 USD (OR, 2.05), annual income of fewer than 36,000 USD (OR 0.669), preferences for home care (OR 1.49), preferences to die at home (OR 1.58), wish to die at home (OR 1.52), and lack of patient's financial well-being (OR 0.72) were significant factors associated with home-based end-of-life care. Significant factors relating to caregivers included male caregivers (OR 0.66), poor mental state (OR 0.79), ability to provide daily care (OR 3.02), experience of caring for a deceased family member (OR 0.66), presence of alternative caregivers (OR 0.78), and cohabitation with caregivers (OR 1.47).

Conclusion: Patient preferences, social situations, primary caregivers' social situations, and mental states influenced home-based end-of-life care.

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来源期刊
Supportive Care in Cancer
Supportive Care in Cancer 医学-康复医学
CiteScore
5.70
自引率
9.70%
发文量
751
审稿时长
3 months
期刊介绍: Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.
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