Impact of dementia on quality of death among cancer patients: An observational study of home palliative care users
Impact of dementia on quality of death among cancer patients: An observational study of home palliative care users
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DOI：
10.1111/ggi.13860
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发表时间：
2020-02-04
影响因子：
3.3
通讯作者：
Nishida, Atsushi
中科院分区：
文献类型：
--
作者：
Hirooka, Kayo;Nakanishi, Miharu;Nishida, Atsushi
目的随着老龄化社会的发展，癌症合并痴呆患者的数量显著增加。癌症患者可能会接受姑息治疗和临终关怀，以维持他们的生活质量；然而，在这一人群中，痴呆症对死亡质量的影响尚未得到检验。因此，我们探讨了痴呆症对癌症患者死亡质量的影响。方法采用良好死亡量表对508例癌症患者的认知状况、癌症相关症状和死亡质量进行问卷调查。对整个样本和基于痴呆存在的分层组进行分层回归分析。结果508例患者中，156例（30.7%）患有痴呆。分层回归分析显示，较高的死亡质量与无痴呆相关（P < 0.001）。分层分析表明，在家中死亡与痴呆患者和非痴呆患者的更高死亡质量有关。主要家庭照顾者的存在仅与痴呆患者更高的死亡质量相关（P < 0.001）。结论：合并痴呆的癌症患者比没有痴呆的癌症患者更不可能获得良好的死亡。我们的研究结果表明，加强与患者及其家属的临终关怀讨论，以及制定具体的支持策略，以提高痴呆症癌症患者及其家属的决策的重要性。Geriatr Gerontol Int 2020；中心网点中心网点：中心网点中心网点中心网点中心网点中心网点。
Aim The number of cancer patients with dementia has increased markedly in accordance with aging societies. Cancer patients might receive palliative and end-of-life care to maintain their quality of life; however, the impact of dementia on the quality of death is unexamined in this population. Consequently, we explored the impact of dementia on the quality of death among cancer patients.Methods Home palliative care staff members completed questionnaires regarding cancer patients' (n = 508) cognitive status, cancer-related symptoms and quality of death using the good death inventory. Hierarchical regression analyses were carried out for the entire sample and for stratified groups based on the presence of dementia.Results Of the 508 patients, 156 (30.7%) had dementia. Hierarchical regression analyses revealed that greater quality of death was associated with not having dementia (P < 0.001). Stratified analyses showed that dying at home was related to greater quality of death both in patients with and without dementia. The presence of a primary family caregiver was associated with greater quality of death only in patients with dementia (P < 0.001).Conclusions Cancer patients with dementia were less likely to achieve a good death than those without. Our results suggest the importance of enhancing end-of-life care discussions with patients and their families, along with developing specific support strategies to enhance the decision-making of cancer patients with dementia and their family members. Geriatr Gerontol Int 2020; center dot center dot: center dot center dot-center dot center dot.