Clinical Care Department, Montreal Institute for Palliative Care, Kirkland, Quebec, Canada.
Clinical Care Department, Teresa Dellar Palliative Care Residence, Kirkland, Quebec, Canada.
J Soc Work End Life Palliat Care. 2024 Apr-Jun;20(2):133-146. doi: 10.1080/15524256.2024.2321330. Epub 2024 Mar 6.
Prediction of life expectancy in terminally ill patients is an important end-of-life care issue for patients, families and mental health workers during the last days of life. This study was conducted to examine the importance/usefulness for patients/families to have an accurate prognosis and its impact on planning their activities prior to death. All patients admitted during a period of one year were included. Patients' and families' viewpoints on the usefulness of an accurate prognosis was documented at admission. There were 285 patients in the cohort. The median time to death was 8 days. Most families (83%) rated the importance of an accurate prognosis as moderately (13%) to very much useful (70%). A total of 42% of patients were able to complete e the questionnaire. Among these, 58% found it moderately to very much useful. For families, having an accurate prognosis influenced the planning of visits (69%), communication/closure (42%) and spiritual needs/funeral arrangements (31%). Patients identified planning of visits (10%), communication/closure (12%), and goals/accomplishments (9%) as very important. Discussing the prognosis and its impact is very helpful for the mental health professionals to have open and honest conversations with patients/families to identify, prioritize and adapt treatment to achieve goals prior to death.
预测终末期患者的预期寿命是患者、家属和心理健康工作者在生命最后几天的重要临终关怀问题。本研究旨在探讨患者/家属获得准确预后的重要性/实用性及其对死亡前规划活动的影响。所有在一年期间入院的患者均纳入研究。在入院时记录了患者及其家属对准确预后有用性的看法。该队列共有 285 名患者。中位死亡时间为 8 天。大多数家属（83%）认为准确预后的重要性为中等（13%）到非常有用（70%）。共有 42%的患者能够完成问卷。其中，58%的患者认为其中等至非常有用。对于家属来说，准确的预后影响了探访的计划（69%）、沟通/结束（42%）和精神需求/葬礼安排（31%）。患者将探访计划（10%）、沟通/结束（12%）和目标/成就（9%）列为非常重要。讨论预后及其影响对于心理健康专业人员来说非常有帮助，可以与患者/家属进行坦诚的对话，以确定、优先考虑并调整治疗方案，以实现死亡前的目标。
