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姑息治疗中管理口渴和口干的新方法:一项前瞻性随机交叉试验。

A Novel Approach to Managing Thirst and Dry Mouth in Palliative Care: A Prospective Randomized Cross-Over Trial.

作者信息

Phelan Caroline, Hammond Lauren, Thorpe Courtney, Allcroft Peter, O'Loughlin Muireann

机构信息

Research Centre for Palliative Care (C.P., L.H., C.T., P.A., M.O.), Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia.

Research Centre for Palliative Care (C.P., L.H., C.T., P.A., M.O.), Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia.

出版信息

J Pain Symptom Manage. 2023 Nov;66(5):587-594.e2. doi: 10.1016/j.jpainsymman.2023.08.005. Epub 2023 Aug 9.

Abstract

CONTEXT

Thirst and xerostomia are significant and highly distressing symptoms experienced by patients receiving palliative and end-of-life care.

OBJECTIVES

Determine a reduction of thirst intensity and perceptions of dry mouth on a numerical scale following both the experimental intervention (mini mint ice cubes) and control (plain ice chips).

METHODS

Cross-over Randomized Controlled Trial (RCT) to assess the effectiveness of novel intervention in the treatment of dry mouth and the sensation of thirst in palliative care patients.

RESULTS

Patients rated the severity of their symptoms of dry mouth and thirst using a numeric rating scale (NRS). On commencing the study and preintervention, all patients suffered severe dry mouth and thirst (≥5/10). Mint and plain ice cubes produced improvement of symptoms immediately after interventions. Results from dry mouth ratings show, a decrease of 1.6 points for plain ice cubes (P < 0.0001), on average, ratings for mint ice cubes decreased 3.7 (P < 0.0001). For the sensation of thirst, the plain ice cube intervention group rating decreased 1.7 points (P < 0.006), ratings for mint ice cubes decreased 3.4 points (P < 0.0001). The average decrease in dry mouth and thirst intensity scores from preintervention to postintervention were significantly greater for mint ice cubes (P < 0.05) and 86.6% of patients preferred mint ice cubes.

CONCLUSION

This trial found that while usual mouth care and the intervention were both able to reduce the intensity of dry mouth and the sensation of thirst, the mint intervention had a greater response.

摘要

背景

口渴和口干是接受姑息治疗和临终关怀的患者所经历的严重且极度痛苦的症状。

目的

确定在实验性干预(薄荷小冰块)和对照(普通冰屑)后,口渴强度和口干感觉在数字量表上的降低情况。

方法

交叉随机对照试验(RCT),以评估新干预措施在治疗姑息治疗患者口干和口渴感觉方面的有效性。

结果

患者使用数字评分量表(NRS)对其口干和口渴症状的严重程度进行评分。在开始研究和干预前,所有患者都遭受严重的口干和口渴(≥5/10)。薄荷冰块和普通冰块在干预后立即改善了症状。口干评分结果显示,普通冰块使评分平均降低1.6分(P<0.0001),薄荷冰块评分平均降低3.7分(P<0.0001)。对于口渴感觉,普通冰块干预组评分降低1.7分(P<0.006),薄荷冰块评分降低3.4分(P<0.0001)。从干预前到干预后,薄荷冰块导致的口干和口渴强度得分平均降低幅度显著更大(P<0.05),86.6%的患者更喜欢薄荷冰块。

结论

该试验发现,虽然常规口腔护理和干预措施都能够降低口干强度和口渴感觉,但薄荷干预的效果更佳。

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