Families' Perceptions of Veterans' Distress Due to Post-Traumatic Stress Disorder-Related Symptoms at the End of Life
Families' Perceptions of Veterans' Distress Due to Post-Traumatic Stress Disorder-Related Symptoms at the End of Life
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DOI：
10.1016/j.jpainsymman.2009.07.011
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发表时间：
2010-03-01
影响因子：
4.7
通讯作者：
Casarett, David J.
中科院分区：
文献类型：
--
作者：
Alici, Yesne;Smith, Dawn;Casarett, David J.
目标。确定临近生命尽头的退伍军人中创伤后应激障碍 (PTSD) 相关症状的频率，并描述这些症状对患者及其家人的影响。方法。患者在生命的最后一个月内从参与的 VA 机构接受了住院或门诊护理，并且使用预定义的资格标准为每位患者选择了一名家庭成员。然后，家庭成员完成了一项电话调查，即临终治疗的家庭评估，该调查评估了他们对患者及其本人在患者生命最后一个月期间接受的护理质量的看法。结果。据报道，17% 的患者（524 名患者中的 89 名）在生命的最后一个月出现过 PTSD 相关症状。 PTSD 相关症状引起不适的频率低于疼痛（平均频率评分 1.79 比 1.93；Wilcoxon 符号等级检验，P < 0.001），但比呼吸困难更常见（平均严重程度评分 1.79 比 1.73；Wilcoxon 符号等级检验，P < 0.001）。患有 PTSD 相关症状的患者家庭成员对患者接受的护理总体满意度较低（平均分 48 比 62；秩和检验，P < 0.001）。接受姑息治疗咨询的患者 (n = 49) 对 PTSD 相关症状造成的不适评分较低（平均 1.55 比 2.07；秩和检验，P = 0.007）。结论。创伤后应激障碍（PTSD）相关症状在临近生命尽头的退伍军人中可能很常见且严重，并可能对家人对退伍军人所接受的护理质量的看法产生负面影响。 J 疼痛症状管理 2010；39：507-514。 (C) 2010 年美国癌症疼痛缓解委员会。由爱思唯尔公司出版。保留所有权利。
Objectives. To define the frequency of post-traumatic stress disorder (PTSD)related symptoms among veterans who are near the end of life and to describe the impact that these symptoms have on patients and their families.Methods. Patients had received inpatient or outpatient care from a participating VA facility in the last month of life, and one family member per patient was selected using predefined eligibility criteria. Family members then completed a telephone survey, The Family Assessment of Treatment at End-of-Life, which assessed their perceptions of the quality of the care that the patients and they themselves received during the patients' last month of life.Results. Seventeen percent of padents (89 of 524) were reported to have had PTSD-related symptoms in the last month of life. PTSD-related symptoms caused discomfort less often than pain did (mean frequency score 1.79 vs. 1.93; Wilcoxon sign rank test, P < 0.001) but more often than dyspnea did (mean severity score 1.79 vs. 1.73; Wilcoxon sign rank test, P < 0.001). Family members of patients with PTSD-related symptoms reported less satisfaction overall with the care the patient received (mean score 48 vs. 62; rank sum test, P < 0.001). Patients who received a palliative care consult (n = 49) had lower ratings of discomfort attributed to PTSD-related symptoms (mean 1.55 vs. 2.07; rank sum test, P = 0.007).Conclusion. PTSD-related symptoms may be common and severe among veterans near the end of life and may have a negative effect on families' perceptions of the quality of care that the veteran received. J Pain Symptom Manage 2010;39:507-514. (C) 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.