Fountain A
St. Johns Hospice in Wirral, Mount Road, Bebington, L63 6JE, UK.
Palliat Med. 2001 Jan;15(1):19-25. doi: 10.1191/026921601674921626.
The aim of the study was to determine the prevalence of visual hallucinations among hospice inpatients, and the prevalence of a number of possible associated risk factors. One hundred consecutive admissions to St. John's Hospice in Wirral were screened for visual hallucinations in a semi-structured interview. The prevalence of opioid administration, other drugs known to cause hallucinations, brain tumours, liver metastases, bone metastases, lung metastases, known renal failure, eye disease, Alzheimer's disease, Parkinson's disease, other neurodegenerative disorder, psychiatric disorder and epilepsy were also recorded. Subjects were screened for cognitive function using the Folstein mini-mental state examination (MMSE). Survival times from assessment to death were calculated. The results were analysed using arithmetical means with 95% confidence intervals (CI) and odds ratios with 95% confidence intervals. Almost half (47%) the patients had experienced visual hallucinations within the previous month. Hypnagogic or hypnopompic hallucinations of a person standing by the bedside were the commonest type. Median survival time for hallucinators was 15 days (range 0-50 days) and for non-hallucinators was 11 days (range 0-89 days). There was no significant difference in cognitive scores between hallucinators and non-hallucinators. Hallucinations were associated with multiple possible risk factors in every case. Hallucinators were more likely to be taking opioids, although the association was not strong (odds ratio 4.48, 95% CI = 1.6-12.19), and were taking larger numbers of potentially hallucinogenic drugs. It is not clear why some patients on opioids hallucinate and others do not. Data on the prevalence of various possible risk factors yielded ample material for the planning of future studies.
该研究的目的是确定临终关怀住院患者中视幻觉的患病率，以及一些可能相关的危险因素的患病率。在一项半结构化访谈中，对连续入住威尔拉尔圣约翰临终关怀院的100名患者进行了视幻觉筛查。还记录了阿片类药物使用、其他已知可导致幻觉的药物、脑肿瘤、肝转移、骨转移、肺转移、已知肾衰竭、眼部疾病、阿尔茨海默病、帕金森病、其他神经退行性疾病、精神疾病和癫痫的患病率。使用福尔斯坦简易精神状态检查表（MMSE）对受试者进行认知功能筛查。计算从评估到死亡的生存时间。结果采用算术平均值及95%置信区间（CI）和比值比及95%置信区间进行分析。近一半（47%）的患者在过去一个月内经历过视幻觉。最常见的类型是在床边看到有人的入睡前或睡醒前幻觉。幻觉患者的中位生存时间为15天（范围0 - 50天），非幻觉患者为11天（范围0 - 89天）。幻觉患者和非幻觉患者的认知评分没有显著差异。在每种情况下，幻觉都与多种可能的危险因素相关。幻觉患者更有可能正在服用阿片类药物，尽管这种关联并不强烈（比值比4.48，95%CI = 1.6 - 12.19），并且正在服用更多数量的潜在致幻药物。尚不清楚为什么一些服用阿片类药物的患者会出现幻觉而另一些患者不会。关于各种可能危险因素患病率的数据为未来研究的规划提供了丰富的资料。
