McCarthy M, Lay M, Addington-Hall J
Department of Epidemiology and Public Health, University College, London.
J R Coll Physicians Lond. 1996 Jul-Aug;30(4):325-8.
To describe the symptoms experienced in the last year of life by people with heart disease, their relation to quality of life, and informal carers' satisfaction with hospital services.
Interview survey of informal carers of 600 patients aged 15 and over, approximately ten months after their death from heart disease in 1990 in 20 English health districts. The districts, while self-selected, were nationally representative in social characteristics and indicators of health service provision and use.
Pain, dyspnoea and low mood were reported to have been experienced by more than half the patients in their last year of life. Anxiety, constipation, nausea/vomiting, urinary incontinence and faecal incontinence, although not suffered by the majority of patients, also caused much distress. Hospital symptom control was reported to be limited: little or no symptom relief was reported for 35% patients with pain, 31% with constipation, 24% with dyspnoea and 24% with nausea/vomiting. Nevertheless, high levels of satisfaction with hospital staff were reported.
Patients dying from heart disease experience a wide range of symptoms, which are frequently distressing, and often last for more than six months. There is room for an improvement in palliative care for patients with heart disease in hospital.
描述心脏病患者在生命最后一年所经历的症状、这些症状与生活质量的关系以及非正式照料者对医院服务的满意度。
对1990年在20个英格兰卫生区因心脏病去世的600名15岁及以上患者的非正式照料者进行访谈调查。这些卫生区虽为自行选择，但在社会特征以及卫生服务提供与使用指标方面具有全国代表性。
据报告，超过半数的患者在生命的最后一年经历过疼痛、呼吸困难和情绪低落。焦虑、便秘、恶心/呕吐、尿失禁和大便失禁，虽然并非大多数患者所遭受的问题，但也造成了很大困扰。据报告，医院对症状的控制有限：35%的疼痛患者、31%的便秘患者、24%的呼吸困难患者和24%的恶心/呕吐患者报告称症状很少或根本没有得到缓解。然而，对医院工作人员的满意度较高。
死于心脏病的患者会经历各种各样的症状，这些症状常常令人痛苦，而且往往持续超过六个月。医院对心脏病患者的姑息治疗还有改进的空间。
