Hentsch Lisa, Pereira Cristiana, Pinon Nathalie, Tahar Aurélie, Pautex Sophie
Division of Palliative Medicine, Geneva University Hospitals, Geneva, Switzerland.
Division of Primary Care, Geneva University Hospitals, Geneva, Switzerland.
Palliat Support Care. 2024 Oct;22(5):938-945. doi: 10.1017/S1478951523000056.
The early introduction of palliative care can have a positive impact on the quality of life of patients suffering from life-limiting diseases. However, the palliative care needs of older, frail, housebound patients are still mostly unknown, as is the impact of frailty on the importance of these needs.
To identify the palliative care needs of frail, older, housebound patients in the community.
We conducted a cross-sectional observational study. This study took place in a single primary care center and included patients who were ≥65 years old, housebound, followed by the Geriatric Community Unit of the Geneva University Hospitals.
Seventy-one patients completed the study. Most patients were female (56.9%), and mean age (SD) was 81.1 (±7.9). The Edmonton Symptom Assessment Scale mean (SD) score was higher in frail patients as opposed to vulnerable patients for tiredness ( = 0.016), drowsiness ( = 0.0196), loss of appetite ( = 0.0124), and impaired feeling of well-being ( = 0.0132). There was no difference in spiritual well-being, measured by the spiritual scale subgroup of the Functional Assessment of the Chronic Illness Therapy-Spiritual Well-Being scale (FACIT-sp) between frail and vulnerable participants, although scores in both groups were low. Caregivers were mainly spouses (45%) and daughters (27.5%) with a mean (SD) age of 70.7 (±13.6). The overall carer-burden measured by the Mini-Zarit was low.
Older, frail, housebound patients have specific needs that differ from non-frail patients and should guide future palliative care provision. How and when palliative care should be provided to this population remains to be determined.
早期引入姑息治疗可对患有危及生命疾病的患者的生活质量产生积极影响。然而，年老体弱、居家患者的姑息治疗需求大多仍不为人知，同样未知的是虚弱对这些需求重要性的影响。
确定社区中体弱、年老、居家患者的姑息治疗需求。
我们进行了一项横断面观察性研究。该研究在一个单一的初级保健中心进行，纳入了年龄≥65岁、居家且由日内瓦大学医院老年社区单元随访的患者。
71名患者完成了研究。大多数患者为女性（56.9%），平均年龄（标准差）为81.1（±7.9）岁。与脆弱患者相比，虚弱患者的埃德蒙顿症状评估量表平均（标准差）得分在疲劳（P = 0.016）、嗜睡（P = 0.0196）、食欲不振（P = 0.0124）和幸福感受损（P = 0.0132）方面更高。通过慢性病治疗功能评估-精神幸福感量表（FACIT-sp）的精神量表亚组测量，虚弱参与者和脆弱参与者之间的精神幸福感没有差异，尽管两组得分都很低。照顾者主要是配偶（45%）和女儿（27.5%），平均（标准差）年龄为70.7（±13.6）岁。用Mini-Zarit量表测量的总体照顾者负担较低。
年老体弱、居家患者有与非体弱患者不同的特殊需求，应指导未来的姑息治疗提供。如何以及何时应为这一人群提供姑息治疗仍有待确定。
