School of Nursing, Midwifery & Social Work, University of Manchester, University Place, Oxford Road, Manchester, UK.
Palliat Med. 2009 Apr;23(3):248-56. doi: 10.1177/0269216309102620. Epub 2009 Feb 27.
This study investigated (a) whether carer bereavement outcome is affected by the achievement of the patient's and/or carers' preferred place of death and (b) the relationship between carer satisfaction with end of life care and bereavement outcome. Participants were 216 carers of patients referred to hospice at home (H@H). Prospective recording of preferred and actual place of death were obtained from H@H records. Carers' level of grief and mental health and assessment of end of life care were obtained through postal survey three to four months post-bereavement. Fulfilment of carer preference for place of death only related to post-bereavement mental health at P < 0.1. Adequacy of psychological support showed the clearest relationship with bereavement outcome both in univariate and multivariate analyses. The level of support, particularly psychological, may be more important for carers' bereavement outcome than achievement of the preferred place of death for the patient.
(a) 丧亲结局是否受到患者和/或照顾者所期望的死亡地点的实现影响；(b) 临终关怀照顾满意度与丧亲结局之间的关系。参与者为 216 名被转诊至居家临终关怀（H@H）的患者的照顾者。通过 H@H 记录前瞻性记录首选和实际死亡地点。通过丧亲后 3 至 4 个月的邮寄调查，获得照顾者的悲伤程度和心理健康评估以及临终关怀评估。仅在 P<0.1 时，满足照顾者对死亡地点的偏好与丧亲后的心理健康有关。心理支持的充分性在单变量和多变量分析中都与丧亲结局有最清晰的关系。支持水平，特别是心理支持，对照顾者的丧亲结局可能比实现患者所期望的死亡地点更为重要。
