Fernandes Samantha, Guthrie Dawn M
a Department of Kinesiology and Physical Education and Health Sciences Program , Wilfrid Laurier University , Waterloo , Ontario , Canada.
Home Health Care Serv Q. 2015;34(1):14-29. doi: 10.1080/01621424.2014.995257.
Individuals with heart failure experience complex symptoms and have a poor prognosis, comparable to those with cancer. However, people with heart failure are less likely to be recognized as needing palliative care. We compared seriously ill home care clients with cancer versus those with heart failure to explore differences between them using existing data from the Resident Assessment Instrument for Home Care (RAI-HC). The sample included 1,475 older adults (65+) in Ontario who had a prognosis of less than 6 months or severe health instability. Clients with heart failure were significantly older (p < .0001) and experienced significantly higher rates of impairment in activities of daily living (p = .005), cognitive impairment (p < .0001), and severe health instability (p < .0001), but were significantly less likely to have a prognosis of less than 6 months (p < .0001). Home care clients with heart failure have needs similar to those with cancer yet are typically not identified as having a terminal prognosis.
心力衰竭患者会经历复杂的症状，且预后较差，堪比癌症患者。然而，心力衰竭患者被认定为需要姑息治疗的可能性较小。我们将患有癌症的重症居家护理客户与患有心力衰竭的客户进行比较，利用居家护理居民评估工具（RAI-HC）的现有数据探究两者之间的差异。样本包括安大略省1475名65岁及以上的老年人，他们的预后少于6个月或健康状况严重不稳定。心力衰竭患者年龄显著更大（p < .0001），日常生活活动受损率显著更高（p = .005），认知障碍发生率显著更高（p < .0001），健康状况严重不稳定的发生率也显著更高（p < .0001），但预后少于6个月的可能性显著更低（p < .0001）。患有心力衰竭的居家护理客户与患有癌症的客户有相似的需求，但通常未被认定为具有终末期预后。
