Min Jiawei, Liu Peihao, Xiao Kaifeng, Huang Zhe, Lai Xiaobin
School of Nursing, Fudan University, Shanghai, China.
Department of Nursing, Shanghai Cancer Center of Fudan University, Shanghai, China.
Int J Nurs Sci. 2024 Mar 8;11(2):179-186. doi: 10.1016/j.ijnss.2024.03.010. eCollection 2024 Apr.
To evaluate the quality of dying and death among deceased patients with cancer in Shanghai from the perspective of healthcare providers.
This cross-sectional study was conducted in Shanghai from April to July 2023. A convenience sample of 261 healthcare providers working at eight healthcare institutions participated. Each participant was asked to evaluate the quality of dying and death of one deceased patient who had been cared for recently using the Good Death Scale for patients in China (GDS-PCN). The scale included family companionship (eight items), dying with peace (six items), professional care (six items), preparation & no regrets (five items), maintaining dignity (four items), keeping autonomy (four items), and physical wellbeing (three items) seven dimensions, 36 items.
The total GDS-PCN score was 144.11 ± 17.86. The professional care dimension scored the highest (4.21 ± 0.58), whereas the preparation and no regret dimension scored the lowest (3.75 ± 0.70). Significant differences in the GDS-PCN scores were based on the healthcare institution grade, ward type, hospitalization duration, communication about the condition, treatment, and death-related topics with the healthcare provider, and decision-making style ( < 0.05). The quality of dying and death of the deceased patients was higher among those who received care in community health service centers and hospice wards, those who had been hospitalized for more than 15 days, those who had discussed their personal conditions, treatment, and death-related topics with healthcare providers to a greater extent; and those who were involved in decision-making ( < 0.05).
The overall quality of dying and death among cancer patients in Shanghai is moderate to high, but the quality of dying and death in the preparation and no regret dimension and the keeping autonomy dimension still have room for improvement. Increased utilization of hospice care and better communication between patients and healthcare providers may enhance decedents' quality of dying and death. Future research on this topic is required from different perspectives and on a broader scale in the mainland of China.
从医疗服务提供者的角度评估上海癌症死亡患者的临终和死亡质量。
本横断面研究于2023年4月至7月在上海进行。选取了在八家医疗机构工作的261名医疗服务提供者作为便利样本。要求每位参与者使用中国患者善终量表（GDS-PCN）对一名近期接受过护理的死亡患者的临终和死亡质量进行评估。该量表包括家庭陪伴（8项）、平静离世（6项）、专业护理（6项）、准备与无悔（5项）、维护尊严（4项）、保持自主（4项）和身体安康（3项）七个维度，共36项。
GDS-PCN总分是144.11±17.86。专业护理维度得分最高（4.21±0.58），而准备与无悔维度得分最低（3.75±0.70）。GDS-PCN得分基于医疗机构等级、病房类型、住院时长、与医疗服务提供者就病情、治疗及死亡相关话题的沟通情况以及决策方式存在显著差异（<0.05）。在社区卫生服务中心和临终关怀病房接受护理的患者、住院超过15天的患者、与医疗服务提供者更多地讨论过个人病情、治疗及死亡相关话题的患者以及参与决策的患者，其死亡患者的临终和死亡质量更高（<0.05）。
上海癌症患者的临终和死亡总体质量中等偏高，但在准备与无悔维度以及保持自主维度的临终和死亡质量仍有提升空间。增加临终关怀的使用以及改善患者与医疗服务提供者之间的沟通可能会提高死者的临终和死亡质量。未来需要在中国内地从不同角度和更广泛的范围对该主题进行研究。
