Bertrand Amandine, Marcault-Derouard Anna, Devaux Yves, Bertrand Yves, Bergeron Christophe, Veyet Véronique, Cervos Marie, Filion Shirley, Goy Florence, Schell Matthias
Centre Léon-Bérard, IHOPe, hospitalisation à domicile pédiatrique, 1, place du Pr-J.-Renaut, 69373 Lyon cedex 08, France.
Centre Léon-Bérard, ERRSPP Rhône-Alpes, ESPPéRA, 1, place du Pr-J.-Renaut, 69373 Lyon cedex 08, France.
Bull Cancer. 2018 Sep;105(9):771-779. doi: 10.1016/j.bulcan.2018.05.007. Epub 2018 Jul 7.
BACKGROUND/OBJECTIVE: Our home-care unit (HCU) is specialized for pediatric cancer patients and has a strong palliative care activity. We believe that the introduction of home-care services can influence the place of palliative care and of death as well as the length of hospitalization. We aimed at describing characteristics and care course of patients treated in our HCU, and tried to identify some factors contributing to home care at the end of life.
DESIGN/METHODS: We conducted a retrospective, observational, monocentric study about patients in pediatric onco-hematology, treated at least one day in our home-care unit, who died between July 1st 2013 and December 31st 2015. Statistical analysis was descriptive and analytic.
A total of 74 patients known by our HCU died during study period. Eight were excluded. Forty-three out of 66 patients died at home. During the last 3 months of life, oncology patients have significantly less classical hospitalization, when compared to hematology patients. The implication of general physicians (GP) and nurses and information given to the family increase the possibility for home death. No significant association was found between ages at death, distance between home and hospital, other life conditions and place of death.
Our HCU has a strong palliative care activity and a high rate of children dying at home. Good collaborations between our pediatric onco-hematology team and our HCU as well as between our HCU and caregivers optimize palliative care.
背景/目的:我们的家庭护理单元(HCU)专门负责小儿癌症患者的护理,并开展了大量姑息治疗活动。我们认为,引入家庭护理服务会对姑息治疗地点、死亡地点以及住院时长产生影响。我们旨在描述在我们家庭护理单元接受治疗的患者的特征和护理过程,并试图找出一些在生命末期有助于实现家庭护理的因素。
设计/方法:我们对2013年7月1日至2015年12月31日期间在我们家庭护理单元接受治疗至少一天且死亡的小儿肿瘤血液科患者进行了一项回顾性、观察性、单中心研究。统计分析采用描述性和分析性方法。
在研究期间,我们家庭护理单元已知的74名患者死亡。其中8名被排除。66名患者中有43名在家中死亡。在生命的最后3个月里,与血液科患者相比,肿瘤科患者的传统住院时间显著减少。全科医生(GP)和护士的参与以及向家属提供的信息增加了在家中死亡的可能性。在死亡年龄、家与医院的距离、其他生活条件与死亡地点之间未发现显著关联。
我们的家庭护理单元开展了大量姑息治疗活动,且儿童在家中死亡的比例很高。我们的小儿肿瘤血液科团队与家庭护理单元之间以及家庭护理单元与护理人员之间的良好合作优化了姑息治疗。