Mogielnicki R P, Nelson W A, Dulac J
Dartmouth Medical School.
J Cancer Educ. 1990;5(2):135-45. doi: 10.1080/08858199009528051.
The dying process was studied by questioning nurses and next of kin of 40 consecutive patients who died in an acute care Veterans Hospital. Information regarding problems commonly thought important in the dying process was elicited and attempts were made to relate this information to global assessments of quality of life during the preterminal week and quality of the moments surrounding death. Despite long-standing awareness of many of these problems, important pain, respiratory difficulty, mood problems, blunted alertness, stooling problems, urination problems, and oral intake problems each was present in at least 50% of patients. Multivariate analysis did not define a convincing relationship between these problems and global assessments of quality. Responses of nurses and next of kin were similar most of the time, but nurses systematically rated pain as less severe than next of kin and next of kin systematically demonstrated less awareness of urinary and stooling problems than nurses.
通过询问在一家急性护理退伍军人医院连续死亡的40名患者的护士和近亲，对死亡过程进行了研究。收集了有关在死亡过程中通常被认为重要的问题的信息，并试图将这些信息与临终前一周的总体生活质量评估以及死亡前后时刻的质量评估联系起来。尽管长期以来人们已经意识到其中许多问题，但至少50%的患者存在严重疼痛、呼吸困难、情绪问题、意识迟钝、排便问题、排尿问题和口腔摄入问题。多变量分析未确定这些问题与总体质量评估之间存在令人信服的关系。护士和近亲的回答大多时候相似，但护士系统性地将疼痛程度评定得比近亲轻，而近亲系统性地比护士对泌尿和排便问题的认识少。
