Jho Hyun Jung, Chang Yoon Jung, Song Hye Young, Choi Jin Young, Kim Yeol, Park Eun Jung, Paek Soo Jin, Choi Hee Jae
Palliative Care Clinic, Hospital, National Cancer Center, Goyang, Republic of Korea.
Support Care Cancer. 2015 Sep;23(9):2805-11. doi: 10.1007/s00520-015-2646-4. Epub 2015 Mar 5.
We aimed to explore the perceived timeliness of referral to hospice palliative care unit (HPCU) among bereaved family members in Korea and factors associated therewith.
Cross-sectional questionnaire survey was performed for bereaved family members of patients who utilized 40 designated HPCUs across Korea. The questionnaire assessed whether admission to the HPCU was "too late" or "appropriate" and the Good Death Inventory (GDI).
A total of 383 questionnaires were analyzed. Of participants, 25.8 % replied that admission to HPCU was too late. Patients with hepatobiliary cancer, poor performance status, abnormal consciousness level, and unawareness of terminal status were significantly related with the too late perception. Family members with younger age and being a child of the patient were more frequently noted in the too late group. Ten out of 18 GDI scores were significantly lower in the too late group. Multiple logistic regression analysis revealed patients' unawareness of terminal status, shorter stay in the HPCU, younger age of bereaved family, and lower scores for two GDI items (staying in a favored place, living without concerning death or disease) were significantly associated with the too late group.
To promote timely HPCU utilization and better quality of end of life care, patients need to be informed of the terminal status and their preference should be respected.
我们旨在探讨韩国丧亲家庭成员对转介至临终关怀姑息治疗病房(HPCU)的及时性认知及其相关因素。
对韩国40家指定HPCU的患者丧亲家庭成员进行横断面问卷调查。问卷评估了入住HPCU是否“太晚”或“合适”以及善终量表(GDI)。
共分析了383份问卷。参与者中,25.8%回答入住HPCU太晚。患有肝胆癌、身体状况差、意识水平异常以及未意识到终末期状态的患者与认为太晚的认知显著相关。年龄较小且是患者子女的家庭成员在认为太晚的组中更为常见。在认为太晚的组中,18项GDI评分中有10项显著较低。多因素逻辑回归分析显示,患者未意识到终末期状态、在HPCU停留时间较短、丧亲家庭成员年龄较小以及两项GDI项目(呆在喜欢的地方、无忧无虑地生活)得分较低与认为太晚的组显著相关。
为促进及时利用HPCU并提高临终关怀质量,需要告知患者终末期状态并尊重其偏好。