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韩国晚期癌症患者的首选护理地点与实际护理地点及与居家出院相关的因素:一项回顾性队列研究

Preferred versus Actual Place of Care and Factors Associated with Home Discharge among Korean Patients with Advanced Cancer: A Retrospective Cohort Study.

作者信息

Hwang In Young, Han Yohan, Kim Min Sun, Kim Kyae Hyung, Cho Belong, Choi Wonho, Kim Yejin, Yoo Shin Hye, Lee Sun Young

机构信息

Public Healthcare Center, Seoul National University Hospital, Seoul 03080, Republic of Korea.

Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Republic of Korea.

出版信息

Healthcare (Basel). 2023 Jul 5;11(13):1939. doi: 10.3390/healthcare11131939.

DOI:10.3390/healthcare11131939
PMID:37444773
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10341285/
Abstract

Respecting the preference for a place of care is essential for advance care planning in patients with advanced cancer. This retrospective study included adult patients with cancer referred to an inpatient palliative care consultation team at a tertiary acute care hospital in South Korea between April 2019 and December 2020. Patients' preference for place of care and demographic and clinical factors were recorded, and the actual discharge locations were categorized as home or non-home. Patients discharged home but with unintended hospital visits within 2 months were also investigated. Of the 891 patients referred to the palliative care consultation team, 210 (23.6%) preferred to be discharged home. Among them, 113 (53.8%) were discharged home. No significant differences were found between patients who preferred home discharge and those who did not. Home discharge was higher among female patients ( = 0.04) and lower in those with poor oral intake ( < 0.001) or dyspnea ( = 0.02). Of the 113 patients discharged home, 37 (32.8%) had unintended hospital visits within 2 months. Approximately one-quarter of hospitalized patients with advanced cancer preferred to be discharged home, but only half of them received the home discharge. To meet patients' preferences for end-of-life care, individual care planning considering relevant factors is necessary.

摘要

尊重晚期癌症患者对护理场所的偏好对于预先护理计划至关重要。这项回顾性研究纳入了2019年4月至2020年12月期间转诊至韩国一家三级急症医院住院姑息治疗咨询团队的成年癌症患者。记录了患者对护理场所的偏好以及人口统计学和临床因素,并将实际出院地点分为回家或非回家。还对出院回家但在2个月内意外就医的患者进行了调查。在转诊至姑息治疗咨询团队的891名患者中,210名(23.6%)希望出院回家。其中,113名(53.8%)出院回家。希望回家出院的患者与不希望回家出院的患者之间未发现显著差异。女性患者回家出院的比例更高( = 0.04),而口服摄入量差( < 0.001)或呼吸困难( = 0.02)的患者回家出院的比例更低。在113名出院回家的患者中,37名(32.8%)在2个月内意外就医。约四分之一的晚期癌症住院患者希望出院回家,但其中只有一半实现了回家出院。为满足患者对临终护理的偏好,有必要考虑相关因素进行个性化护理计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26d1/10341285/984bc1dabea5/healthcare-11-01939-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26d1/10341285/dab2493357e2/healthcare-11-01939-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26d1/10341285/b56628bdca99/healthcare-11-01939-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26d1/10341285/984bc1dabea5/healthcare-11-01939-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26d1/10341285/dab2493357e2/healthcare-11-01939-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26d1/10341285/b56628bdca99/healthcare-11-01939-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/26d1/10341285/984bc1dabea5/healthcare-11-01939-g003.jpg

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本文引用的文献

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J Antimicrob Chemother. 2023 Jul 5;78(7):1694-1700. doi: 10.1093/jac/dkad156.
2
The impact of palliative care consultation on reducing antibiotic overuse in hospitalized patients with terminal cancer at the end of life: a propensity score-weighting study.姑息治疗会诊对减少晚期癌症住院患者临终时抗生素过度使用的影响:一项倾向评分加权研究。
J Antimicrob Chemother. 2022 Dec 23;78(1):302-308. doi: 10.1093/jac/dkac405.
3
Predictors of the final place of care of patients with advanced cancer receiving integrated home-based palliative care: a retrospective cohort study.
接受综合家庭姑息治疗的晚期癌症患者最终护理地点的预测因素:一项回顾性队列研究。
BMC Palliat Care. 2021 Oct 18;20(1):164. doi: 10.1186/s12904-021-00865-5.
4
The Situation of Life-Sustaining Treatment One Year after Enforcement of the Act on Decisions on Life-Sustaining Treatment for Patients at the End-of-Life in Korea: Data of National Agency for Management of Life-Sustaining Treatment.韩国《末期患者维持生命治疗决定法》实施 1 年后的维持生命治疗状况:国家维持生命治疗管理机构数据。
Cancer Res Treat. 2021 Oct;53(4):897-907. doi: 10.4143/crt.2021.327. Epub 2021 Jun 2.
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Life-Sustaining Treatment States in Korean Cancer Patients after Enforcement of Act on Decisions on Life-Sustaining Treatment for Patients at the End of Life.《终末期患者维持生命治疗决定法案》实施后韩国癌症患者的维持生命治疗意愿状况
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