End-of-Life Healthcare Service Needs Among Children With Neurological Conditions: A Latent Class Analysis.
End-of-Life Healthcare Service Needs Among Children With Neurological Conditions: A Latent Class Analysis.
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DOI：
10.1097/jnn.0000000000000615
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发表时间：
2021-12-01
期刊：
影响因子：
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通讯作者：
Fortney CA
中科院分区：
文献类型：
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作者：
Lindley LC;Svynarenko R;Mooney-Doyle K;Mendola A;Naumann WC;Fortney CA
在生命的尽头，患有神经系统疾病的儿童有复杂的医疗保健需求，可以通过在临终关怀的同时提供他们的生命限制条件的护理（即并发护理）来满足。鉴于有限的文献同时照顾儿童神经系统疾病，这项调查的目的是确定模式的非临终关怀，医疗保健服务的需求，并评估每个组内的儿童的特点。一个具有全国代表性的样本儿童与神经系统疾病登记在并行临终关怀。潜在类别分析（LCA）和描述性统计进行了计算，以确定模式的卫生保健需求和特点的儿童组内。对婴儿进行了亚组分析。在1 601名儿童中，最常见的服务类型是住院医院、耐用医疗设备和家庭保健。确定了两类服务需求：中等强度（58%）和高强度（42%）。中等强度组的儿童主要是1至5岁的男性、白人和非西班牙裔。最常见的神经系统疾病是CNS变性。他们还患有显著的合并症、精神/行为健康状况和技术依赖。他们通常居住在南方的城市地区。高强度组的儿童有广泛的神经系统疾病和高敏度。婴儿的亚组分析表明不同的神经学特征。两个不同的类非临终关怀，医疗保健服务的需求出现在儿童神经系统疾病在生命的尽头。这些群体具有独特的人口特征。
At the end of life, children with neurological conditions have complex health care needs that can be met by providing care of their life-limiting conditions concurrently with hospice care (i.e. concurrent care). Given the limited literature on concurrent care for children with neurologic conditions, this investigation aimed to identify patterns of non-hospice, health care service needs and to assess characteristics of children within each group. A nationally representative sample children with neurological conditions enrolled in concurrent hospice care was used. Latent class analysis (LCA) and descriptive statistics were calculated to identify patterns of health care needs and characteristics of children within the groups. A subgroup analysis of infants was conducted. Among the 1,601 children, the most common types of services were inpatient hospitals, durable medical equipment, and home health. Two classes of service needs were identified: moderate-intensity (58%) and high-intensity (42%). Children in the moderate-intensity group were predominantly between 1 to 5-years of age, male, Caucasian, and non-Hispanic. The most common neurological condition was CNS degeneration. They also had significant comorbidities, mental/behavioral health conditions, and technology dependence. They commonly resided in urban areas in the South. Children in the high-intensity group had a wide range of neurological conditions and high acuity. The subgroup analysis of infants indicated a different neurological profile. Two distinct classes of non-hospice, health care services needs emerged among children with neurological conditions at end of life. The groups had unique demographic profiles.