Karlsson Inga Lill Källström, Ehnfors Margareta, Ternestedt Britt-Marie
Department of Health Sciences, Orebro University, Orebro, Sweden.
Scand J Caring Sci. 2006 Jun;20(2):113-21. doi: 10.1111/j.1471-6712.2006.00387.x.
The hospice philosophy with focus on the patient's autonomy and the ideal of a good death are the overall objectives of palliative care. Often-raised questions, when discussing hospice, are for which of the incurable ill inpatient hospice is the most optimal care alternative together with who are making use of hospice. The aim of the present study was to describe patient characteristics such as age, marital status, diagnosis, referral source and length of stay (LoS) in relation to gender, during the first decade at an inpatient hospice ward (1992-2001). Data, obtained from medical register, were analysed by using descriptive statistics and the chi-square test. The number of patients was 666 women and 555 men, and most of them were elderly. In some respects significant differences were observed between women and men. More women than men were single, had cancer with relatively rapid trajectory and were referred from the oncology department. Men, more often than women, were diagnosed with cancers with a somewhat longer trajectory. Despite the longer trajectory, the LoS was shorter for men (median =13 days) than for women (median = 17 days). The most frequent referral source was hospital, though men, younger men in particular, were more often referred from home-based hospice care than women. During the last 3 years self-referrals were documented. Self-referrals can be seen as one distinct expression from a standpoint of one's own active choice compared with other referrals. Altogether, self-referrals were less frequent among women than men but in relation to age, self-referrals were more common among the youngest (<60 years) and the oldest women (>85 years) than men in the same age groups. Further studies illuminating a gender perspective can broaden the understanding of what these differences may imply for women and men.
以患者自主权和安详离世理念为核心的临终关怀哲学是姑息治疗的总体目标。在讨论临终关怀时，经常会提出的问题是，对于哪些不治之症患者而言，住院临终关怀是最佳的护理选择，以及哪些人在使用临终关怀服务。本研究的目的是描述在一家住院临终关怀病房的头十年（1992 - 2001年）期间，与性别相关的患者特征，如年龄、婚姻状况、诊断、转诊来源和住院时长（LoS）。从医疗记录中获取的数据通过描述性统计和卡方检验进行分析。患者人数为666名女性和555名男性，其中大多数是老年人。在某些方面，观察到了男性和女性之间的显著差异。单身女性比男性更多，患有病程相对较快的癌症，且从肿瘤科转诊而来。男性比女性更常被诊断患有病程稍长的癌症。尽管病程较长，但男性的住院时长（中位数 = 13天）比女性（中位数 = 17天）短。最常见的转诊来源是医院，不过男性，尤其是年轻男性，比女性更常从居家临终关怀护理机构转诊而来。在最后3年有自我转诊记录。与其他转诊相比，自我转诊可被视为一种基于自身主动选择的独特表现。总体而言，女性的自我转诊比男性少，但就年龄而言，最年轻（<60岁）和最年长（>85岁）女性中的自我转诊比同年龄组的男性更常见。进一步从性别视角进行阐释的研究可以拓宽对这些差异可能对男性和女性意味着什么的理解。
