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韩国晚期癌症患者死亡地点的相关因素。

Factors associated with place of death in koprean patients with terminal cancer.

作者信息

Hyun Min Kyung, Jung Kyung Hae, Yun Young Ho, Kim Young Ae, Lee Woo Jin, Do Young Rok, Lee Keun Seok, Heo Dae Seog, Choi Jong Soo, Kim Sam Yong, Kim Heung Tae, Kim Seok-Won

机构信息

National Evidence-based Healthcare Collaborating Agency, Seoul, Korea E-mail :

出版信息

Asian Pac J Cancer Prev. 2013;14(12):7309-14.

Abstract

AIM

To investigate factors that affect the place of death (POD) of terminal cancer patients.

MATERIALS AND METHODS

We recruited 702 consecutive patients (>18 years) from 12 centers during July 2005 to October 2006, and 481 completed the questionnaire. In April 2011, we linked the data for 96.0% (n=462) of the deceased patients to the POD using the 2005-2009 death certificate data of Korea's National Statistical Office. The primary outcome variable was POD, and the predictive value of variables pertaining to patients and caregivers was evaluated using univariate and multivariate analyses.

RESULTS

Most patients died in a hospital (91.5%, n=441) and age, education, preference for place of terminal care, wish to use hospice/palliative care services, terminal cancer awareness, time between diagnosis and death, and global quality-of-life subscale of the EORTC QLQ-C30 of patients, and education and preference for place of terminal care of caregivers were significant predictors in univariate analyses. On multivariate analysis, patients and caregivers who preferred hospital/palliative care as the terminal care option over home care [adjusted odds ratio (aOR), 2.68; 95% confidential interval (CI), 1.18- 7.04 and aOR: 2.65; 95%CI: 1.15-6.09 for patient and caregiver preferences, respectively] and caregivers who were highly educated (aOR, 3.19; 95%CI, 1.44-7.06) were predictors of POD.

CONCLUSIONS

Most of the terminal cancer patients died in a hospital. Our findings indicate that major predictors of hospital deaths are preference of both the patient and caregiver for hospital/palliative care as the terminal care option and higher education of the caregiver.

摘要

目的

探讨影响晚期癌症患者死亡地点的因素。

材料与方法

2005年7月至2006年10月期间,我们从12个中心连续招募了702例年龄大于18岁的患者,其中481例完成了问卷调查。2011年4月,我们利用韩国国家统计局2005 - 2009年的死亡证明数据,将96.0%(n = 462)的已故患者数据与死亡地点进行了关联。主要结局变量是死亡地点,通过单因素和多因素分析评估了与患者及照料者相关变量的预测价值。

结果

大多数患者在医院死亡(91.5%,n = 441)。在单因素分析中,患者的年龄、教育程度、终末期护理地点偏好、使用临终关怀/姑息治疗服务的意愿、对晚期癌症的认知、诊断至死亡的时间、欧洲癌症研究与治疗组织核心问卷(EORTC QLQ - C30)的总体生活质量子量表,以及照料者的教育程度和终末期护理地点偏好均为显著预测因素。多因素分析显示,与家庭护理相比,患者和照料者更倾向于选择医院/姑息治疗作为终末期护理方式的[调整优势比(aOR),2.68;95%可信区间(CI),1.18 - 7.04,患者和照料者偏好的aOR分别为2.65;95%CI:1.15 - 6.09],以及受过高等教育的照料者(aOR,3.19;95%CI,1.44 - 7.06)是死亡地点的预测因素。

结论

大多数晚期癌症患者在医院死亡。我们的研究结果表明,医院死亡的主要预测因素是患者和照料者都倾向于选择医院/姑息治疗作为终末期护理方式,以及照料者受教育程度较高。

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