Symptom Relief and Palliative Care during the Last Week of Life among Patients with Heart Failure: A National Register Study
Symptom Relief and Palliative Care during the Last Week of Life among Patients with Heart Failure: A National Register Study
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DOI：
10.1089/jpm.2017.0125
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发表时间：
2018-03-01
影响因子：
2.8
通讯作者：
Brannstrom, Margareta
中科院分区：
文献类型：
--
作者：
Arestedt, Kristofer;Alvariza, Anette;Brannstrom, Margareta
背景：心力衰竭是一种高发病率、高死亡率、高身心负担的疾病。需要更多关于为濒临死亡的心力衰竭患者提供护理的知识。目标：其目的是描述医疗保健专业人员报告的心力衰竭患者生命最后一周姑息治疗的关键方面。设计：这是一项国家注册研究。背景/受试者：该研究纳入了3981例诊断为心力衰竭的潜在死因患者。测量值：数据来自瑞典姑息治疗登记处，这是一个国家质量登记处，重点关注患者生命的最后一周，与诊断或护理环境无关。该登记册包括与姑息治疗的关键方面有关的护理干预措施的信息。数据由患者死亡的医疗单位的护士或医生回顾性报告。结果：只有4.2%的心力衰竭患者接受了专门的姑息治疗。在他们生命的最后一周，症状患病率很高，验证量表很少使用，症状缓解不满意。研究中约五分之一（17%）的患者独自死亡。不到一半的家庭成员得到了丧亲支助（45%）。此外，三分之一（28%）的患者和超过一半（61%）的家庭成员在疾病轨迹期间与医生进行了临终讨论。结论：结果表明，在生命的最后一周，心力衰竭患者的姑息治疗不足。
Background: Heart failure is a disease with high morbidity, mortality, and physical and psychological burden. More knowledge about the care provided for patients with heart failure close to death is needed. Objective: The aim was to describe key aspects of palliative care during the last week of life in patients with heart failure, as reported by healthcare professionals. Design: This is a national register study. Setting/Subjects: The study included 3981 patients with diagnosed heart failure as the underlying cause of death. Measurements: Data were obtained from the Swedish Register of Palliative Care, a national quality register that focuses on patients' last week of life, independent of diagnosis or care setting. The register includes information about care interventions connected with key aspects of palliative care. Data are reported retrospectively by a nurse or physician at the healthcare unit where the patient dies. Results: Only 4.2% of patients with heart failure received specialized palliative care. In their last week of life, symptom prevalence was high, validated scales were seldom used, and symptoms were unsatisfactorily relieved. Around one-fifth (17%) of the patients in the study died alone. Less than half of family members had been offered bereavement support (45%). Moreover, one-third (28%) of the patients and more than half (61%) of the family members were reported to have had end-of-life discussions with a physician during the illness trajectory. Conclusion: The results indicate inadequate palliative care for patients with heart failure during their last week of life.