The last two days of life of nursing home patients - a nationwide study on causes of death and burdensome symptoms in the Netherlands
The last two days of life of nursing home patients - a nationwide study on causes of death and burdensome symptoms in the Netherlands
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DOI：
10.1191/0269216306pm1164oa
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发表时间：
2006-01-01
影响因子：
4.4
通讯作者：
Ribbe, Miel W.
中科院分区：
文献类型：
--
作者：
Brandt, Hella E.;Ooms, Marcel E.;Ribbe, Miel W.
目的：本研究的目的是确定绝症疗养院 (NH) 患者生命最后两天的直接死亡原因并评估是否存在繁重症状。方法：对荷兰 16 家有代表性的疗养院 (n = 463) 中最长预期寿命为六周的患者进行前瞻性研究。在意识清醒的患者死亡后，使用埃德蒙顿症状评估量表 (ESAS) 和居民评估工具最低数据集姑息治疗（RAI MDS-PC 草案 1.8）测量症状。对所有患者的直接死亡原因进行了评估。结果：大多数患者死于肺炎、肾衰竭或脱水。意识丧失很常见。死亡前48小时和24小时出现繁重症状的比例分别为51.3%和28.4%。结论：在实践中，对于许多患者来说，生命的最后几天似乎是在无意识或有意识的情况下度过的，伴随着一种或多种繁重的症状，这表明改善症状管理的潜力。
Objectives: The aim of this study was to identify the direct causes of death and to evaluate the presence of burdensome symptoms in the last two days of life of terminally ill nursing home (NH) patients. Methods: Prospective study of patients with a maximum life-expectancy of six weeks in 16 nursing homes representative for the Netherlands (n = 463). Symptoms were measured after death in conscious patients with the Edmonton Symptom Assessment Scale (ESAS) and the Resident Assessment Instrument Minimum Data-Set Palliative Care (RAI MDS-PC draft 1.8). Direct causes of death were assessed in all patients. Results: Most patients died from pneumonia, renal failure or dehydration. Loss of consciousness was common. The prevalence of burdensome symptom(s) at 48 and 24 hours before death was 51.3 and 28.4%, respectively. Conclusion: In practice, it appears that, for many patients, the last days of life are spent unconscious or conscious with one or more burdensome symptom(s), which suggests the potential for improvement of symptom management.