养老院的临终关怀：2004年全国养老院调查
End-of-life care in nursing homes: 2004 National Nursing Home Survey.
作者信息
Bercovitz Anita, Decker Frederic H, Jones Adrienne, Remsburg Robin E
机构信息
U.S. Department of Health & Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, MD 20782, USA.
出版信息
Natl Health Stat Report. 2008 Oct 8(9):1-23.
OBJECTIVES
This report presents information on nursing home residents receiving end-of-life (EOL) care in nursing homes. Residents receiving EOL care are compared with those not receiving EOL care on demographics, functional and cognitive status, reported pain, medications, and diagnoses. Residents receiving EOL care are further categorized by whether they started EOL care on or prior to admission to the nursing home or after admission to the nursing home. These two groups receiving EOL care are compared with each other on demographics, functional and cognitive status, medications, diagnoses, length of time receiving EOL care, and treatments received.
METHODS
Data are from the resident component of the 2004 National Nursing Home Survey (NNHS). The 2004 NNHS is a nationally representative, cross-sectional probability sample survey of all current residents in nursing homes in the United States with three or more beds and either certified by Medicare or Medicaid or licensed by the state. All information is derived from interviews with nursing home staff.
RESULTS
Nursing home residents receiving EOL care were older, more functionally and cognitively impaired, and more likely to have reported pain in the previous 7 days compared with nursing home residents not receiving EOL care. They were also more likely to have at least one advance directive. Three-fourths of residents who received EOL care in the nursing home started EOL care after admission to the nursing home. Differences in age, functional impairment, and cognitive impairment were observed among residents receiving EOL care depending on when they started EOL care. However, no differences in services and treatments received were observed depending on whether EOL care started on or prior to admission or after admission to the nursing home. The mean length of time on EOL care was approximately 5 months and did not differ by whether the care started on or prior to admission or after admission to the nursing home.
目的
本报告提供了有关养老院中接受临终关怀（EOL）的居民的信息。将接受临终关怀的居民与未接受临终关怀的居民在人口统计学、功能和认知状态、报告的疼痛、用药情况及诊断方面进行比较。接受临终关怀的居民进一步按其在入住养老院之前或之时开始接受临终关怀，还是在入住养老院之后开始接受临终关怀进行分类。将这两组接受临终关怀的居民在人口统计学、功能和认知状态、用药情况、诊断、接受临终关怀的时长以及接受的治疗方面进行相互比较。
方法
数据来自2004年全国养老院调查（NNHS）的居民部分。2004年NNHS是一项具有全国代表性的横断面概率抽样调查，对象为美国所有拥有三张或更多床位、由医疗保险或医疗补助认证或由州颁发执照的养老院中的现住居民。所有信息均来自对养老院工作人员的访谈。
结果
与未接受临终关怀的养老院居民相比，接受临终关怀的养老院居民年龄更大，功能和认知障碍更严重，并且在过去7天内更有可能报告疼痛。他们也更有可能至少有一份预先医疗指示。在养老院接受临终关怀的居民中，四分之三在入住养老院后开始接受临终关怀。根据开始接受临终关怀的时间不同，接受临终关怀的居民在年龄、功能障碍和认知障碍方面存在差异。然而，无论临终关怀是在入住之前或之时开始还是在入住之后开始，在接受的服务和治疗方面均未观察到差异。临终关怀的平均时长约为5个月，且无论护理是在入住之前或之时开始还是在入住之后开始，时长并无差异。
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