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预测患者在姑息治疗入院时与相关利益、负担和安全感的因素:一项横断面调查。

Predictors of patient-related benefit, burden and feeling safe in relation to hospital admissions in palliative care: A cross-sectional survey.

机构信息

1 School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.

2 Auckland City Hospital, Auckland, New Zealand.

出版信息

Palliat Med. 2018 Jan;32(1):167-171. doi: 10.1177/0269216317731991. Epub 2017 Sep 27.

Abstract

BACKGROUND

Research exploring patient experience of palliative care in the hospital setting has previously been limited to negative aspects of care. However, recent studies have shown that patients with palliative care needs experience benefits being in hospital. Little is known about how experiences of benefit and burden vary according to socio-demographic and illness-related factors and how these experiences influence patient preferences to return to hospital.

AIM

To identify factors influencing experiences of benefit and burden and the predictors associated with a preference to return to hospital in palliative care.

DESIGN

Cross-sectional design using a questionnaire survey.

SETTING/PARTICIPANTS: In total, 116 hospital inpatients admitted with palliative care needs in an urban hospital in New Zealand. Recruitment was from an oncology ward, four general medical wards and a respiratory ward.

RESULTS

Those living in more deprived areas experienced more benefit being in hospital ( F(4, 109) = 3.15, p = 0.017), while younger people ( F(4, 109) = 4.44, p = 0.00) and those from Asian or Pacific cultures ( F(2, 111) = 7.78, p = 0.000) experienced more burden. Those with a non-cancer diagnosis felt less safe in hospital ( p = 0.04). 'Feeling safe' was a significant ( B = 0.14, p = 0.03) predictor for a preference to return to hospital.

CONCLUSION

Deprivation, diagnosis, age and ethnicity influenced experiences of benefit and burden in hospital. 'Feeling safe' was a significant predictor for a preference to return to hospital. Further research is needed to understand why certain patient factors influence experiences of hospitalisation and how 'feeling safe' can be replicated in other care environments.

摘要

背景

先前,探索医院环境中姑息治疗患者体验的研究仅限于护理的负面方面。然而,最近的研究表明,有姑息治疗需求的患者在住院期间会体验到益处。对于受益和负担的体验如何根据社会人口学和疾病相关因素而有所不同,以及这些体验如何影响患者返回医院的偏好,人们知之甚少。

目的

确定影响受益和负担体验的因素,以及与返回姑息治疗医院的偏好相关的预测因素。

设计

使用问卷调查的横断面设计。

设置/参与者:共有 116 名在新西兰一家城市医院因姑息治疗需求住院的住院患者。招募来自肿瘤科病房、四个普通内科病房和一个呼吸科病房。

结果

居住在较贫困地区的人在住院时受益更多( F(4, 109) = 3.15,p = 0.017),而年轻人( F(4, 109) = 4.44,p = 0.00)和来自亚洲或太平洋文化的人( F(2, 111) = 7.78,p = 0.000)则感到更多的负担。非癌症诊断的人在医院感到更不安全( p = 0.04)。“感到安全”是返回医院的偏好的一个显著( B = 0.14,p = 0.03)预测因素。

结论

贫困、诊断、年龄和种族影响了住院期间的受益和负担体验。“感到安全”是返回医院偏好的一个显著预测因素。需要进一步研究,以了解为什么某些患者因素会影响住院体验,以及如何在其他护理环境中复制“感到安全”。

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