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[马德里某健康区域晚期肿瘤患者生活质量与各种居家护理模式的关系]

[Relationship between quality of life and various models of home care in terminal oncology patients from a health area of Madrid].

作者信息

Agra Varela Yolanda, Sacristán Rodea Antonio, Pelayo Alvarez Marta, Fernández Julia

机构信息

Centro de Salud Pacífico, Area 1 IMSALUD, Madrid.

出版信息

Rev Esp Salud Publica. 2003 Sep-Oct;77(5):567-79.

Abstract

BACKGROUND

This study assesses the effectiveness of the palliative home care for the purpose of ascertaining whether terminal cancer patients treated by Homecare Support Teams have a better quality of life than those treated by Primary Care Teams.

METHODS

A quasi-experimental prospective study conducted in Madrid Healthcare District 4 on patients referred from the hospital to Homecare Support Teams or to Primary Care Teams. The main study variable was the quality of life gauged using the Rotterdam Symptom Check List and the Hospital Anxiety and Depression Scale. Statistical differences were evaluated by MANOVA, repeated measures ANOVA and Friedman test.

RESULTS

A total of 165 patients were treated by Homecare Support Teams and 56 by Primary Care Teams. The patients treated by the Homecare Support Teams showed better point scores on the overall scale (mean difference: 9.5; CI 95%; 2.3-16.67) and pain scale Symptom Check List during the first week of the study. The effect size was greater on the Homecare Support Team group. The prescription of drugs and the place of death were different between both groups.

CONCLUSIONS

At the start of the study, the patients treated by Homecare Support Teams showed a better perception of the health condition than those treated by the Primary Care Teams. However, the great number of patients lost along the study makes it necessary be cautious when considering these results.

摘要

背景

本研究评估姑息性家庭护理的有效性,目的是确定由家庭护理支持团队治疗的晚期癌症患者是否比由初级保健团队治疗的患者生活质量更高。

方法

在马德里第4医疗区对从医院转介至家庭护理支持团队或初级保健团队的患者进行了一项准实验性前瞻性研究。主要研究变量是使用鹿特丹症状检查表和医院焦虑抑郁量表衡量的生活质量。通过多变量方差分析、重复测量方差分析和弗里德曼检验评估统计学差异。

结果

共有165名患者由家庭护理支持团队治疗,56名由初级保健团队治疗。在研究的第一周,由家庭护理支持团队治疗的患者在总体量表(平均差异:9.5;95%置信区间;2.3 - 16.67)和症状检查表疼痛量表上的得分更高。家庭护理支持团队组的效应量更大。两组之间的药物处方和死亡地点不同。

结论

在研究开始时,由家庭护理支持团队治疗的患者对健康状况的感知比由初级保健团队治疗的患者更好。然而,由于研究过程中大量患者失访,在考虑这些结果时需要谨慎。

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