Heckel M, Stiel S, Frauendorf T, Hanke R M, Ostgathe C
Palliativmedizinische Abteilung, Comprehensive Cancer Center (CCC) Erlangen-EMN, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen, Nürnberg.
Spezialisierte Ambulante Palliativversorgung (SAPV), Fürth.
Gesundheitswesen. 2016 Jul;78(7):431-7. doi: 10.1055/s-0034-1396807. Epub 2015 Jan 26.
Specialised outpatient palliative care teams (in Germany called SAPV) aim to ensure best possible end-of-life care for outpatients with complex needs. Information on the influence of living areas (rural vs. urban) on patient and care related aspects is rare. This study aims to explore differences between palliative care patients in urban and rural dwellings concerning their nursing and service characteristics.
A retrospective data analysis of documentary data for 502 patients supplied by SAPV team from December 2009 to June 2012 was conducted. Patients and care characteristics were investigated by frequency analysis and were compared for both groups of urban and rural dwelling patients (T test, Chi², Fisher's exact test p < 0.05).
387 complete data sets could be included. Urban (n=197) and rural (n=190) dwelling patients were almost equally sized groups. The mean age of the whole sample was 74.5 years, 55.3% were female. Most patients were diagnosed with cancer (76.8%). No significant differences in urban and rural dwelling patients concerning most demographics, care, disease and service related aspects of palliative home care could be detected. An exception is that the rate of re-admittance to hospital is higher for rural dwelling patients (Fisher's exact test p=0.022).
Although predominantly presumed, the single service analysis shows - except for the re-admittance rate to hospital - no considerable differences between palliative care patients regarding their living area. Our findings indicate that patients cared for in rural and urban settings have similar needs and impose similar requirements on palliative care teams.
专业门诊姑息治疗团队（在德国称为SAPV）旨在确保为有复杂需求的门诊患者提供尽可能最佳的临终关怀。关于居住地区（农村与城市）对患者及护理相关方面影响的信息很少。本研究旨在探讨城市和农村住宅中姑息治疗患者在护理和服务特征方面的差异。
对2009年12月至2012年6月期间SAPV团队提供的502例患者的文献数据进行回顾性数据分析。通过频率分析调查患者和护理特征，并对城市和农村居住患者两组进行比较（T检验、卡方检验、Fisher精确检验，p<0.05）。
可纳入387个完整数据集。城市（n = 197）和农村（n = 190）居住患者的分组规模几乎相同。整个样本的平均年龄为74.5岁，55.3%为女性。大多数患者被诊断患有癌症（76.8%）。在大多数人口统计学、护理、疾病和姑息家庭护理服务相关方面，未发现城市和农村居住患者之间存在显著差异。一个例外是农村居住患者再次入院的比率较高（Fisher精确检验，p = 0.022）。
尽管大多是推测，但单项服务分析显示——除了再次入院率——姑息治疗患者在居住地区方面没有显著差异。我们的研究结果表明，在农村和城市环境中接受护理的患者有相似的需求，对姑息治疗团队提出了相似的要求。
