School of Population and Global Health, The University of Western Australia, Perth, WA, Australia.
Monash Nursing and Midwifery, Monash University, Clayton, VIC, Australia.
Eur J Cancer Care (Engl). 2021 Jan;30(1):e13331. doi: 10.1111/ecc.13331. Epub 2020 Oct 27.
To (a) compare palliative care needs of lung cancer patients on their final admission to community-based and inpatient palliative care services; and (b) explore whether and how these care needs affect their utilisation of different palliative care services in the last days of life.
Descriptive study involving 17,816 lung cancer patients who received the last episode of palliative care from specialist services and died between 1 January 2013 and 31 December 2018.
Both groups of patients admitted to community-based and inpatient palliative care services generally experienced relatively low levels of symptom distress, but high levels of functional impairment and dependency. "Unstable" versus "stable" palliative care phase (Odds ratio = 11.66; 95% Confidence Interval: 9.55-14.24), poorer functional outcomes and severe levels of distress from many symptoms predicted greater likelihood of use of inpatient versus community-based palliative care.
Most inpatient palliative care admissions are not associated with high levels of symptom severity. To extend the period of home care and rate of home death for people with lung cancer, additional investment is required to improve their access to sufficiently skilled palliative care staff, multi-disciplinary teams and 24-hour home support in community settings.
(a) 比较肺癌患者在最后一次入院至社区和住院姑息治疗服务时的姑息治疗需求；(b) 探讨这些需求如何影响他们在生命最后几天对不同姑息治疗服务的利用。
本描述性研究纳入了 17816 名于 2013 年 1 月 1 日至 2018 年 12 月 31 日期间因肺癌最后一次接受专科姑息治疗服务并死亡的患者。
两组入院接受社区和住院姑息治疗服务的患者一般都经历了相对较低水平的症状困扰，但存在较高水平的功能损伤和依赖。“不稳定”与“稳定”的姑息治疗阶段（比值比=11.66；95%置信区间：9.55-14.24）、较差的功能结局以及许多症状的严重困扰程度预示着更有可能使用住院而非社区姑息治疗。
大多数住院姑息治疗入院与高症状严重程度无关。为了延长肺癌患者的家庭护理时间和居家死亡比例，需要增加投入，以便他们能够更好地获得足够熟练的姑息治疗人员、多学科团队以及社区环境中的 24 小时家庭支持。
