Liu Huiqin, Cook Angus, Ding Jinfeng, Lu Hongwei, Jiao Jingjing, Bai Wenhui, Johnson Claire E
Health Management Center, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
Department of Cardiology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
BMJ Support Palliat Care. 2023 Jul 27. doi: 10.1136/spcare-2023-004280.
(1) To compare palliative care needs of patients admitted primarily with stroke and (2) to determine how the care needs of these patients affect their use of different types of specialist palliative care services.
Observational study based on point-of-care data from the Australian Palliative Care Outcomes Collaboration. Multivariate logistic regression models were used to explore the association between patients' palliative care needs and use of community versus inpatient specialist palliative care services.
The majority of patients who had a stroke in this study population had mild or no symptom distress, but experienced a high degree of functional impairment and needed substantial help with basic tasks of daily living. A lower Australia-modified Karnofsky Performance Status score (OR=1.82, 95% CI 1.06 to 3.13) and occurrence of an 'unstable' palliative care phase (OR=28.34, 95% CI 9.03 to 88.94) were associated with use of inpatient versus community palliative care, but otherwise, no clear association was observed between the majority of symptoms and use of different care services.
Many people with stroke could potentially have been cared for and could have experienced the terminal phases of their condition in a community setting if more community support services were available for their families.
（1）比较主要因中风入院患者的姑息治疗需求；（2）确定这些患者的护理需求如何影响他们对不同类型专科姑息治疗服务的使用。
基于澳大利亚姑息治疗结果协作组织的即时护理数据进行观察性研究。使用多变量逻辑回归模型探讨患者的姑息治疗需求与社区姑息治疗服务和住院专科姑息治疗服务使用之间的关联。
本研究人群中大多数中风患者症状轻微或无症状困扰，但功能障碍程度较高，在日常生活基本任务方面需要大量帮助。较低的澳大利亚改良卡诺夫斯基功能状态评分（OR = 1.82，95% CI 1.06至3.13）和出现“不稳定”的姑息治疗阶段（OR = 28.34，95% CI 9.03至88.94）与住院姑息治疗与社区姑息治疗的使用相关，但除此之外，大多数症状与不同护理服务的使用之间未观察到明显关联。
如果能为中风患者的家庭提供更多社区支持服务，许多中风患者可能在社区环境中得到护理，并经历病情的终末期。
