Evidence-based Research Centre, Faculty of Health, Edge Hill University, St Helen's Road, Ormskirk, Lancashire, UK.
Health Soc Care Community. 2010 Jul;18(4):337-45. doi: 10.1111/j.1365-2524.2009.00897.x. Epub 2009 Dec 20.
For patients dying of cancer, there is an emphasis on giving choice regarding preferred location for care, with the option of dying at home, which is integral to UK government health initiatives such as the End of Life Care Programme. However, patients continue to be admitted to hospital in the terminal phase of their illness when they have expressed a desire to die at home. A qualitative study, using two audio tape-recorded focus group interviews, with a purposive sample of district nurses and community specialist palliative care nurses (19) was undertaken across two primary care trusts in the north west of England. Data were analysed using a thematic analysis approach. From a service provision perspective, the results reveal that poor discharge planning and co-ordination, difficulty in establishing additional equipment and services together with inadequate out of hours medical provision were all factors contributing to hospital admissions for patients with cancer in the last hours and days of life, and thus were barriers to dying at home.
对于癌症晚期患者，重点在于让他们可以根据自己的意愿选择临终关怀的地点，包括选择在家中离世，这是英国政府卫生倡议（如临终关怀计划）的重要组成部分。然而，尽管患者在生命的终末期表达了在家中离世的愿望，他们仍会被收治住院。本研究采用定性研究方法，在英格兰西北部的两个基层医疗信托中，通过 purposive 抽样选择了 19 名地区护士和社区专科姑息治疗护士，使用两段录音焦点小组访谈进行研究。采用主题分析方法对数据进行分析。从服务提供的角度来看，研究结果表明，出院计划和协调不佳、难以一起安装额外的设备和服务以及医疗资源在非工作时间不足等因素，都导致癌症患者在生命的最后几个小时和几天内仍住院治疗，这也成为他们在家中离世的障碍。
