接受住院姑息治疗的患者感知痛苦的变化。
Changes in perceived distress among patients receiving inpatient palliative care.
机构信息
Division of Cardiovascular Medicine, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
Graduate Institute of Senior Healthcare Management, Tamkang University, Yilan, Taiwan.
出版信息
Support Care Cancer. 2024 Nov 25;32(12):820. doi: 10.1007/s00520-024-09033-w.
CONTEXT
Understanding the impact of palliative care on patient outcomes is crucial for enhancing end-of-life care.
OBJECTIVES
This study aimed to examine changes in perceived distress among patients receiving inpatient palliative care.
METHODS
In this retrospective cohort study, data were collected from a palliative care unit in central Taiwan between January and December 2021. Patients were categorized into "survived to discharge" and "non-survivor" groups based on discharge status. The Symptom Assessment Scale (SAS) was used to measure subjective distress daily during hospitalization. SAS scores on the admission day were compared to days 3 and 7, with changes analyzed using the chi-square test.
RESULTS
A total of 191 patients were included in the study. Significant differences in symptom intensity changes were observed for sleep disturbance, appetite problems, bowel issues, breathing difficulties, fatigue, and pain during the first week of hospitalization. In the "non-survivor" group, improvements in pain were noted over time; however, distress related to appetite, bowel function, and fatigue worsened. Conversely, the "survived to discharge" group showed continuous improvement in sleep disturbance and breathing distress throughout the hospitalization period.
CONCLUSION
This study offers insights into how inpatient palliative care differentially influences perceived distress based on patients' end-of-life stage. Enhancements in palliative care approaches are needed to more comprehensively support patients, particularly those nearing the end of life.
背景
了解姑息治疗对患者结局的影响对于加强临终关怀至关重要。
目的
本研究旨在考察接受住院姑息治疗患者感知痛苦的变化。
方法
这是一项回顾性队列研究,数据来自 2021 年 1 月至 12 月台湾中部的一个姑息治疗病房。根据出院情况,将患者分为“存活至出院”和“非存活”组。使用症状评估量表(SAS)每天在住院期间测量主观痛苦。将入院当天的 SAS 评分与第 3 天和第 7 天进行比较,使用卡方检验分析变化。
结果
共纳入 191 例患者。在住院的第一周,睡眠障碍、食欲问题、肠道问题、呼吸困难、疲劳和疼痛的症状强度变化存在显著差异。在“非存活”组中,疼痛随时间的推移逐渐改善;然而,与食欲、肠道功能和疲劳相关的痛苦恶化。相比之下,“存活至出院”组在整个住院期间持续改善睡眠障碍和呼吸窘迫。
结论
本研究深入了解了住院姑息治疗如何根据患者临终阶段的不同而对感知痛苦产生影响。需要改进姑息治疗方法,以更全面地支持患者,特别是那些生命即将结束的患者。