Department of Epidemiology and Public Health, UCL, London, UK.
Age Ageing. 2010 Jan;39(1):86-91. doi: 10.1093/ageing/afp212. Epub 2009 Nov 23.
there is limited understanding of symptoms and care in the last few months of life for adults dying from causes other than cancer.
the aim of the study is to compare the experiences in the community in the last 3 months of life of older adults dying from cancer and non-cancer causes.
the study employed a retrospective cross-sectional survey of bereaved relatives.
the survey took place across eight cancer networks in England.
a random sample of 1,266 adults who registered a death occurring in someone aged 65 and over between August 2002 and February 2004 was drawn.
VOICES (Views of Informal Carers-Evaluation of Services) questionnaires were sent to sampled informants by the Office for National Statistics 3-9 months after the registration of the death. Differences in the reported experiences of cancer and non-cancer decedents in symptoms, treatment and care were assessed using Pearson's chi square test.
cancer decedents were significantly more likely than non-cancer decedents to have had pain (93 vs 79%, P < 0.001), nausea and vomiting (62 vs 40%, P < 0.001) and constipation (74 vs 66%, P = 0.03), whilst a greater proportion of non-cancer decedents experienced breathlessness (74 vs 65%, P = 0.006). Across both groups, less than half of the decedents were reported to have received treatment which completely relieved their symptoms some or all of the time. There were significant variations in the receipt of district nursing, general practitioner care and other health and social care and the reported quality of this care, for decedents dying of cancer and non-cancer causes. Further, informants for cancer deaths reported greater satisfaction with support received.
there are important differences in the reported experiences of older adults dying from cancer and non-cancer causes in the last months of life, independent of age.
对于非癌症原因导致死亡的成年人，他们在生命的最后几个月的症状和护理情况了解有限。
本研究旨在比较癌症和非癌症原因导致死亡的老年人在生命的最后 3 个月在社区中的经历。
本研究采用回顾性横断面调查，调查对象为丧亲的亲属。
该调查在英格兰的 8 个癌症网络中进行。
随机抽取 2002 年 8 月至 2004 年 2 月期间登记的年龄在 65 岁及以上的某人死亡的 1266 名成年人的随机样本。
在死亡登记后 3-9 个月，由国家统计局通过办公室向抽样告知者发送 VOICES（非正式护理人员意见评估服务）问卷。使用 Pearson 卡方检验评估癌症和非癌症死者在症状、治疗和护理方面报告的经历差异。
与非癌症死者相比，癌症死者更有可能出现疼痛（93%比 79%，P<0.001）、恶心和呕吐（62%比 40%，P<0.001）和便秘（74%比 66%，P=0.03），而非癌症死者更有可能出现呼吸困难（74%比 65%，P=0.006）。在两组中，不到一半的死者报告说他们接受的治疗完全缓解了他们的症状，有时甚至是全部时间。死于癌症和非癌症的死者接受区域护理、全科医生护理以及其他卫生和社会护理的情况以及报告的护理质量存在显著差异。此外，癌症死亡的告知者报告说对所获得的支持更满意。
对于非癌症原因导致死亡的老年人，他们在生命的最后几个月的经历与癌症原因导致死亡的老年人有很大的不同，这与年龄无关。
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