Choi Yanghwan, Park Myoungrin, Kang Da Hyun, Lee Jooseon, Moon Jae Young, Ahn Heejoon
Department of Burn and Critical Care, Bestian Hospital, Osong, Korea.
Department of Internal Medicine, Daejeon Veterans Hospital, Daejeon, Korea.
Acute Crit Care. 2019 Aug;34(3):192-201. doi: 10.4266/acc.2018.00374. Epub 2019 Apr 8.
To identify the necessary care for dying patients in intensive care units (ICUs), we designed a retrospective study to evaluate the quality of dying and death (QODD) experienced by the surrogates of patients with medical illness who died in the ICU of a tertiary referral hospital.
To achieve our objective, the authors compared the QODD scores as appraised by the relatives of patients who died of cancer under hospice care with those who died in the ICU. For this study, a Korean version of the QODD questionnaire was developed, and individual interviews were also conducted.
Sixteen people from the intensive care group and 23 people from the hospice care group participated in the survey and completed the questionnaire. The family members of patients who died in the ICU declined participation at a high rate (50%), with the primary reason being to avoid bringing back painful memories (14 people, 87.5%). The relatives of the intensive care group obtained an average total score on the 17-item QODD questionnaire, which was significantly lower than that of the relatives of the hospice group (48.7±15.5 vs. 60.3±14.8, P=0.03).
This work implies that there are unmet needs for the care of dying patients and for the QODD in tertiary hospital ICUs. This result suggests that shared decision making for advance care planning should be encouraged and that education on caring for dying patients should be provided to healthcare professionals to improve the QODD in Korean ICUs.
为确定重症监护病房（ICU）中临终患者所需的护理，我们设计了一项回顾性研究，以评估在一家三级转诊医院的ICU中死亡的内科疾病患者的替代者所经历的死亡质量（QODD）情况。
为实现我们的目标，作者比较了接受临终关怀的癌症死亡患者亲属与在ICU死亡患者亲属对QODD的评分。在本研究中，开发了韩文版的QODD问卷，并进行了个人访谈。
重症监护组的16人和临终关怀组的23人参与了调查并完成了问卷。在ICU死亡患者的家属拒绝参与的比例很高（50%），主要原因是避免唤起痛苦的回忆（14人，87.5%）。重症监护组亲属在17项QODD问卷上的平均总分显著低于临终关怀组亲属（48.7±15.5对60.3±14.8，P = 0.03）。
这项工作表明，三级医院ICU中临终患者的护理和QODD存在未满足的需求。这一结果表明，应鼓励在预先护理计划方面进行共同决策，并应向医疗保健专业人员提供有关护理临终患者的教育，以提高韩国ICU中的QODD。
