The Palliative Specialist Team, Department of Oncology, Aarhus University Hospital, Noerrebrogade, Aarhus, Denmark.
BMC Palliat Care. 2009 Dec 14;8:18. doi: 10.1186/1472-684X-8-18.
Most terminally ill cancer patients and their relatives wish that the patient dies at home. Community nurses (CNs) are often frontline workers in the patients' homes and CN involvement may be important in attaining successful palliative pathways at home.The aim of the present study was to examine associations between bereaved relatives' evaluation of palliative treatment at home and 1) place of death and 2) CN involvement.
The study is a population-based, cross-sectional combined register and questionnaire study performed in Aarhus County, Denmark. CN questionnaires were used to obtain data on CNs' efforts, GP-questionnaires were used to obtain data on pathway characteristics and relatives answered questionnaires to evaluate the palliative pathway at home. Questionnaires addressed the palliative pathway of a total of 599 deceased cancer patients. Associations between bereaved relatives' evaluation of palliative pathways at home and place of death and CN involvement were analysed.
'A successful palliative pathway at home' was positively associated with home-death and death at a nursing home compared with death at an institution. No significant associations were identified between the evaluations of the palliative pathway at home and the involvement of CNs.
Our study indicates that dying at home is positively associated with a higher likelihood that the bereaved relative will evaluate the palliative pathway at home as successful. The absence of any significance of involvement of CNs may be ascribed to the variables for involvement chosen in the study. More research is needed on CNs' impact on palliative pathways.
大多数患有绝症的癌症患者及其家属希望患者在家中去世。社区护士（CNs）通常是患者家中的一线工作人员，CN 的参与对于实现家庭姑息治疗的成功路径可能非常重要。本研究的目的是调查临终亲属对家庭姑息治疗的评估与 1）死亡地点和 2）CN 参与之间的关联。
本研究是在丹麦奥胡斯郡进行的一项基于人群的横断面联合登记和问卷调查研究。CN 问卷用于获取 CN 努力的数据，GP 问卷用于获取路径特征数据，亲属回答问卷以评估家庭姑息治疗路径。问卷共涉及 599 名已故癌症患者的姑息治疗路径。分析临终亲属对家庭姑息治疗路径的评估与死亡地点和 CN 参与之间的关联。
“家庭姑息治疗路径成功”与在家中死亡和在养老院死亡相比，与在机构中死亡呈正相关。在家中姑息治疗路径的评估与 CN 参与之间未发现显著关联。
我们的研究表明，在家中去世与临终亲属更有可能评估家庭姑息治疗路径成功呈正相关。CN 参与的重要性在研究中选择的参与变量中可能没有体现。需要进一步研究 CN 对姑息治疗路径的影响。
