Falk Hanna, Henoch Ingela, Ozanne Anneli, Öhlen Joakim, Ung Eva Jakobsson, Fridh Isabell, Sarenmalm Elisabeth Kenne, Falk Kristin
Assistant Professor, The Sahlgrenska Academy, University of Gothenburg, Institute of Health and Care Sciences, Gothenburg, Sweden.
Assistant Professor, University of Gothenburg, Centre for Ageing and Health (AGECAP), Gothenburg, Sweden.
J Nurs Scholarsh. 2016 Nov;48(6):569-576. doi: 10.1111/jnu.12254. Epub 2016 Sep 26.
To explore patient-reported symptom distress in relation to documentation of symptoms and palliative care designation in hospital inpatients.
This cross-sectional study analyzed data from 710 inpatients at two large hospitals in Sweden using the Edmonton Symptom Assessment Scale and the Memorial Symptom Assessment Scale. Chart reviews focused on nurses' and physicians' symptom documentation and palliative turning point.
Descriptive statistics were calculated for all variables and provided summaries about the sample. Patients were grouped according to gender, age, palliative care designation, and symptom documentation. The t test and chi-square test were used to calculate whether symptom distress varied between groups. A two-way analysis of variance was conducted for multiple comparisons to explore the impact of gender and age on mean symptom distress.
Females reported higher levels of symptom distress than did males related to pain, fatigue, and nausea. When comparing symptom distress between males and females with documentation pertaining to symptoms, there were significant differences implying that females had to report higher levels of symptom distress than males in order to have their symptoms documented.
Females need to report higher levels of symptom distress than do males for healthcare professionals to identify and document their symptoms. It can be hypothesized that females are not receiving the same attention and symptom alleviation as men. If so, this highlights a serious inequality in care that requires further exploration.
Considering that common reasons why people seek health care are troublesome symptoms of illness, and that the clinical and demographic characteristics of inpatients are changing towards more advanced ages with serious illnesses, inadequate symptom assessment and management are a serious threat to the care quality.
探讨患者报告的症状困扰与医院住院患者症状记录及姑息治疗指定之间的关系。
这项横断面研究使用埃德蒙顿症状评估量表和纪念症状评估量表分析了瑞典两家大型医院710名住院患者的数据。病历审查聚焦于护士和医生的症状记录以及姑息治疗转折点。
计算所有变量的描述性统计量，并提供样本总结。患者按性别、年龄、姑息治疗指定和症状记录进行分组。使用t检验和卡方检验计算症状困扰在各组之间是否存在差异。进行双向方差分析以进行多重比较，探讨性别和年龄对平均症状困扰的影响。
女性报告的与疼痛、疲劳和恶心相关的症状困扰水平高于男性。在比较有症状记录的男性和女性之间的症状困扰时，存在显著差异，这意味着女性为了使自己的症状得到记录，必须报告比男性更高水平的症状困扰。
女性需要比男性报告更高水平的症状困扰，以便医护人员识别并记录她们的症状。可以假设女性没有得到与男性相同的关注和症状缓解。如果是这样，这凸显了护理中严重的不平等，需要进一步探究。
考虑到人们寻求医疗保健的常见原因是疾病带来的麻烦症状，并且住院患者的临床和人口统计学特征正朝着年龄更大、病情更严重的方向变化，症状评估和管理不足对护理质量构成严重威胁。
