Bruera E, Kuehn N, Emery B, Macmillan K, Hanson J
Palliative Care Program, Edmonton General Hospital, Alberta, Canada.
J Palliat Care. 1990 Winter;6(4):16-20.
In this retrospective study we reviewed the charts of 169 consecutive admissions to the Palliative Care Unit, Edmonton General Hospital. Demographic and social characteristics of patients were assessed in order to determine the likelihood that the patients could be managed at home according to currently available services. The mean age of the population was 65 +/- 12 years, 97 (57%) were women, they had a variety of cancers with major prevalence of the most frequent adult tumors, and 72% of patients were coming from acute care hospitals. Each patient had an average of 2.7 +/- 1.8 children (median = 3), a mean of 0.18 +/- 0.6 dependents (median = 0), a mean of 1 +/- 0.9 support persons at home (median = 1), and a mean of 2.6 +/- 1 support persons outside the household (median = 2). Of a total of 119 main caregivers who lived in the same household as the patient, 69 (58%) were not able to take care of the patient. Only 27 patients (16%) considered that there were major financial problems, and all 169 patients had universal health care available (95 patients had additional private health care coverage). Of 125 patients who were asked where they preferred to die, 112 (90%) stated that they did not want to die at home. Our data suggest that the lack of family support and lack of intensive home care services are the main obstacles to home care of terminally ill cancer patients in our province. Home care services as currently available are not able to care for a large number of patients with terminal cancer. More prospective research into this subject is badly needed.
在这项回顾性研究中,我们查阅了埃德蒙顿总医院姑息治疗科连续收治的169例患者的病历。对患者的人口统计学和社会特征进行了评估,以确定根据现有服务患者能够在家中接受治疗的可能性。研究人群的平均年龄为65±12岁,97例(57%)为女性,患有多种癌症,其中最常见的是成人常见肿瘤,72%的患者来自急症医院。每位患者平均有2.7±1.8个子女(中位数=3),平均有0.18±0.6个受抚养人(中位数=0),平均有1±0.9个在家中的照料者(中位数=1),平均有2.6±1个家庭外的照料者(中位数=2)。在与患者同住一个家庭的119名主要照料者中,69名(58%)无法照料患者。只有27名患者(16%)认为存在重大经济问题,所有169名患者都享有全民医保(95名患者还有额外的私人医保覆盖)。在被问及希望在哪里去世的125名患者中,112名(90%)表示不想在家中去世。我们的数据表明,缺乏家庭支持和缺乏密集的家庭护理服务是我省晚期癌症患者居家护理的主要障碍。现有的家庭护理服务无法照料大量晚期癌症患者。急需对此主题进行更多前瞻性研究。