End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium.
Int Psychogeriatr. 2013 Oct;25(10):1697-707. doi: 10.1017/S1041610213000756. Epub 2013 Jun 5.
Providing good quality care for the growing number of patients with dementia is a major challenge. There is little international comparative research on how people with dementia die in nursing homes. We compared the relative's judgment on quality of care at the end of life and quality of dying of nursing home residents with dementia in Belgium and the Netherlands.
This was a Belgian cross-sectional retrospective study (2010) combined with a prospective and retrospective study from the Netherlands (January 2007-July 2011). Relatives of deceased residents of 69 Belgian and 34 Dutch nursing homes were asked to complete questionnaires. We included 190 and 337 deceased nursing home residents with dementia in Belgium and the Netherlands, respectively.
Of all identified deceased nursing home residents with dementia, respectively 53.2% and 74.8% of their relatives in Belgium and the Netherlands responded. Comfort while dying (CAD-EOLD, range 14-42) was rated better for Dutch nursing home residents than for Belgian nursing homes residents (26.1 vs. 31.1, OR 4.5, CI 1.8-11.2). We found no differences between countries regarding Satisfaction With Care (SWCEOLD, range 10-40, means 32.5 (the Netherlands) and 32.0 (Belgium)) or symptom frequency in the last month of life (SM-EOLD, range 0-45, means 26.4 (the Netherlands) and 27.2 (Belgium)).
Although nursing home structures differ between Belgium and the Netherlands, the quality of care in the last month of life for residents with dementia is similar according to their relatives. However, Dutch residents experience less discomfort while dying. The results suggest room for improved symptom management in both countries and particularly in the dying phase in Belgium.
为不断增多的痴呆症患者提供高质量的护理是一项重大挑战。国际上对疗养院中痴呆症患者的死亡方式比较研究较少。我们比较了比利时和荷兰疗养院中痴呆症患者临终时护理质量和临终质量的亲属判断。
这是一项比利时的横断面回顾性研究（2010 年），结合了荷兰的前瞻性和回顾性研究（2007 年 1 月至 2011 年 7 月）。69 家比利时和 34 家荷兰疗养院中去世居民的亲属被要求填写问卷。我们分别纳入了 190 名和 337 名比利时和荷兰疗养院中患有痴呆症的去世居民。
在所有确定的疗养院中患有痴呆症的去世居民中，比利时和荷兰的亲属分别有 53.2%和 74.8%做出回应。荷兰疗养院居民临终时的舒适度（CAD-EOLD，范围 14-42）评分高于比利时疗养院居民（26.1 分比 31.1 分，OR 4.5，CI 1.8-11.2）。我们未发现两国在护理满意度（SWCEOLD，范围 10-40，平均值 32.5（荷兰）和 32.0（比利时））或生命最后一个月的症状频率（SM-EOLD，范围 0-45，平均值 26.4（荷兰）和 27.2（比利时））方面存在差异。
尽管比利时和荷兰的疗养院结构不同，但根据亲属的说法，痴呆症患者生命最后一个月的护理质量相似。然而，荷兰居民临终时的不适感较小。结果表明，这两个国家都有改善症状管理的空间，尤其是在比利时的临终阶段。
