School of Health Administration, Dalhousie University, and Surveillance and Epidemiology Unit, Cancer Care Nova Scotia, Halifax, Nova Scotia.
School of Health Administration, Dalhousie University, Halifax, Nova Scotia.
Can J Diabetes. 2015 Feb;39(1):29-35. doi: 10.1016/j.jcjd.2014.01.009. Epub 2014 Jul 22.
To determine the need for diabetes mellitus palliative care, we identified persons with a diagnosis of diabetes who accessed palliative care programs and those who may have benefited from a palliative approach to care.
This retrospective, descriptive research used 6 linked databases comprising 66 634 Nova Scotians from 3 health districts who died between 1995 and 2009, each with access to a palliative care program and diabetes centres.
The percentage of persons with diabetes enrolled in palliative care increased from 3.2% in 1995 to 34.3% in 2009; 31.5% were enrolled within their last 2 weeks of life. Most did not have their diabetes recorded in palliative data. Among the 5353 persons with a diagnosis of diabetes who died between 2005 and 2009, 61.0% were in the Diabetes Care Program of Nova Scotia registry. An additional 19.6% were identified in the Cardiovascular Health Nova Scotia registry, and a further 3.7% in palliative data. Applying the criteria of Rosenwax et al to the 5353, 65.8% to 97.9% may have benefitted from a palliative approach.
Rates of palliative enrollment for persons with diabetes are increasing. Diabetes care providers need to prepare patients and their families for changes in diabetes management that will be beneficial as end of life approaches. Collaboration among chronic disease programs, palliative care and primary care is advised to identify persons at end of life who have diabetes and to develop and implement care guidelines for this population.
为了确定是否需要对糖尿病患者进行姑息治疗，我们确定了接受姑息治疗项目的糖尿病患者和可能受益于姑息治疗方法的患者。
本回顾性描述性研究使用了 6 个链接数据库，共包括来自 3 个卫生区的 66634 名在 1995 年至 2009 年间去世的新斯科舍人，他们每个人都可以获得姑息治疗项目和糖尿病中心的服务。
1995 年至 2009 年间，参加姑息治疗的糖尿病患者比例从 3.2%上升至 34.3%；31.5%的患者在生命的最后 2 周内参加了姑息治疗。大多数患者的糖尿病并未在姑息治疗数据中记录。在 2005 年至 2009 年间去世的 5353 名患有糖尿病的患者中，61.0%在新斯科舍省糖尿病护理计划登记处。另有 19.6%的患者在心血管健康新斯科舍登记处登记，另有 3.7%的患者在姑息治疗数据中登记。应用 Rosenwax 等人的标准对 5353 名患者进行评估，65.8%至 97.9%的患者可能受益于姑息治疗方法。
接受姑息治疗的糖尿病患者比例正在增加。糖尿病护理提供者需要为患者及其家属做好准备，以应对糖尿病管理方面的变化，这些变化在接近生命终点时是有益的。建议慢性病项目、姑息治疗和初级保健之间开展合作，以确定生命末期患有糖尿病的患者，并为这一人群制定和实施护理指南。
