Buchanan Robert J, Choi Maryann, Wang Suojin, Huang Chunfeng
Department of Health Policy and Management, School of Rural Public Health, The Texas A&M University System Health Science Center, College Station, Texas 77843-1266, USA.
Palliat Med. 2002 Nov;16(6):465-80. doi: 10.1191/0269216302pm589oa.
To present comprehensive profiles of residents in hospice care at admission to the nursing home using the Minimum Data Set (MDS).
We analysed 40,622 MDS admission assessments for nursing home residents in hospice care. The MDS contains resident-focused data on pain, cognitive patterns, physical function, disease diagnoses, medications, nutrition, and specific treatments received.
About four in five recently admitted hospice residents had 'do not resuscitate' orders and only 27% had a living will. Over 70% of recently admitted hospice residents experienced pain, with almost one half experiencing daily pain. Over one half of those hospice residents in pain experienced moderate pain and almost one third experienced horrible or excruciating pain. About 57% of recently admitted hospice patients had cancer, 21 % had congestive heart failure, 20% had emphysema/chronic obstructive pulmonary disease, and 18% had depression. About one in two recently admitted hospice residents exhibited at least moderate impairment in cognitive function.
There is a need to improve pain management, advanced directives, and mental health services for residents dying in nursing homes.
使用最小数据集（MDS）呈现临终关怀居民入住养老院时的综合概况。
我们分析了40622份养老院临终关怀居民的MDS入院评估。MDS包含以居民为中心的数据，涉及疼痛、认知模式、身体功能、疾病诊断、药物、营养以及接受的特定治疗。
近五分之四新入住的临终关怀居民有“不要复苏”医嘱，只有27%有生前预嘱。超过70%新入住的临终关怀居民经历疼痛，近一半居民每天都经历疼痛。疼痛的临终关怀居民中，超过一半经历中度疼痛，近三分之一经历严重或极度疼痛。约57%新入住的临终关怀患者患有癌症，21%患有充血性心力衰竭，20%患有肺气肿/慢性阻塞性肺疾病，18%患有抑郁症。近二分之一新入住的临终关怀居民表现出至少中度的认知功能损害。
有必要改善养老院临终居民的疼痛管理、生前预嘱和心理健康服务。
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