Otani Hiroyuki, Morita Tatsuya, Igarashi Naoko, Shima Yasuo, Miyashita Mitsunori
Department of Palliative Care Team, and Palliative and Supportive Care, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
Department of Palliative Care Team, and Palliative and Supportive Care, St. Mary's Hospital, Fukuoka, Japan.
Palliat Med Rep. 2020 Dec 3;1(1):174-178. doi: 10.1089/pmr.2020.0058. eCollection 2020.
During end-of-life care, the place in which the patients spend time influences their quality of life. To clarify what it means to spend last days at home and in inpatient hospice. This study was a part of a nationwide multicenter questionnaire survey of bereaved family members of cancer patients evaluating the quality of end-of-life care in Japan. A nationwide questionnaire survey was conducted with 779 family members of cancer patients who had died at inpatient hospices. We asked participants about the perceived benefits of spending last days at home and inpatient hospice during the patient's last days. A nationwide questionnaire. Of participants, 37.6% ( = 185 [95% confidence interval, 33%-42%]) felt that the inpatient hospice was like a home. The family members who reported that the inpatient hospice felt like home significantly tended to report high satisfaction with the level of care ( < 0.01). Factors that the participants perceived as benefits of the inpatient hospice were: "If anything changes, as health care professionals are easily available, he/she can handle it" (88.1%), "he/she is reassured" (78.4%), and "he/she is safe" (72.7%). On the contrary, factors that they perceived as benefits of home were: "He/she can do what he/she wants to do without worrying about the eye of other people" (44.1%), "he/she can relax" (43.5%), and "he/she is free" (42.0%). Spending the last days of life in either an inpatient hospice or at home has specific benefits. The place a patient spends his/her end-of-life days should be based on patient and family values.
在临终关怀期间，患者度过时光的场所会影响他们的生活质量。为了阐明在家庭和住院临终关怀机构度过最后时光的意义。本研究是一项全国多中心问卷调查的一部分，该调查针对日本癌症患者的 bereaved 家庭成员，评估临终关怀的质量。对 779 名在住院临终关怀机构去世的癌症患者的家庭成员进行了全国范围的问卷调查。我们询问参与者关于在患者最后时光在家庭和住院临终关怀机构度过最后时光的感知益处。一项全国性问卷调查。在参与者中，37.6%（=185[95%置信区间，33%-42%]）认为住院临终关怀机构像家一样。报告住院临终关怀机构感觉像家的家庭成员显著倾向于对护理水平报告高满意度（<0.01）。参与者认为住院临终关怀机构的益处因素有：“如果有任何变化，由于医护人员随时可得，他/她能够应对”（88.1%），“他/她感到安心”（78.4%），以及“他/她很安全”（72.7%）。相反，他们认为家庭的益处因素有：“他/她可以做自己想做的事而不用担心他人的眼光”（44.1%），“他/她可以放松”（43.5%），以及“他/她是自由的”（42.0%）。在住院临终关怀机构或家中度过生命的最后时光都有特定的益处。患者度过其临终时光的场所应基于患者和家庭的价值观。 （注：“bereaved”常见释义为“丧失亲人的” ，这里结合语境推测表示癌症患者去世后其家庭成员）
