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约旦一家三级癌症中心治疗的患者的死亡地点。

Place of death for patients treated at a tertiary cancer center in Jordan.

机构信息

Faculty of Medicine, Internal Medicine Department, Jordan University of Science and Technology, Irbid, Jordan.

School of Nursing, University of Jordan, Amman, Jordan.

出版信息

Support Care Cancer. 2021 Apr;29(4):1837-1842. doi: 10.1007/s00520-020-05677-6. Epub 2020 Aug 11.

Abstract

BACKGROUND

Home death is considered to be a marker of good death. Little is known about the place of death and its determinants in patients with cancer in Jordan.

METHODS

A retrospective analysis of regularly collected data of cancer patients who had a palliative care consultation at King Hussein Cancer Center and died between 2011 and 2012. Variables analyzed were related to the patient, disease, and palliative care services. Patient-related factors included age at death, gender, place of residence, and code status; disease-related variables were cancer type (solid vs hematological), major primary site, and time from cancer diagnosis to death; palliative care service-related variables included time of consultation for palliative care services to death, location of first palliative encounter (outpatient clinic vs hospital floor), multidisciplinary palliative home care teams involvement, and the number of home care visits before death. We examined the association between each variable and place of death using Pearson's chi-square and the Mann-Whitney tests. Factors with statistical significance of P value < 0.1 were entered into multivariate logistic regression model.

RESULTS

Among 630 patients, 80 (12.7%) died at home. Univariate analysis showed the following to be significantly associated with dying at home: male gender, age more than 65 years old, earlier palliative care involvement, and involvement of home care services (P value < 0.05). Independent predictors for dying at home were male gender, age more than 65 years old, and involvement of home care services.

CONCLUSIONS

Hospital death is more prevalent than home death in cancer patients in Jordan. Involvement of home care services can help achieve the goal of dying at home.

摘要

背景

在家中去世被认为是善终的标志。在约旦,人们对癌症患者的死亡地点及其决定因素知之甚少。

方法

对 2011 年至 2012 年期间在侯赛因国王癌症中心接受姑息治疗咨询并死亡的癌症患者的定期收集数据进行回顾性分析。分析的变量与患者、疾病和姑息治疗服务有关。患者相关因素包括死亡时的年龄、性别、居住地和医嘱执行状况;疾病相关变量包括癌症类型(实体瘤与血液系统肿瘤)、主要原发部位和从癌症诊断到死亡的时间;姑息治疗服务相关变量包括姑息治疗服务咨询到死亡的时间、首次姑息治疗的地点(门诊诊所与医院病房)、多学科姑息治疗家庭护理团队的参与情况以及死亡前的家庭护理访问次数。我们使用 Pearson's chi-square 和 Mann-Whitney 检验来检验每个变量与死亡地点之间的关联。P 值<0.1 的统计学显著因素被纳入多变量逻辑回归模型。

结果

在 630 名患者中,有 80 名(12.7%)在家中去世。单因素分析显示,以下因素与在家中去世显著相关:男性、年龄大于 65 岁、较早接受姑息治疗以及家庭护理服务的参与(P 值<0.05)。在家中去世的独立预测因素是男性、年龄大于 65 岁和家庭护理服务的参与。

结论

在约旦,癌症患者的医院死亡比在家中死亡更为普遍。家庭护理服务的参与可以帮助实现在家中去世的目标。

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