The impact of death rattle on bereaved families: not the sound itself, but the resonance with their feelings.
The impact of death rattle on bereaved families: not the sound itself, but the resonance with their feelings.
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临死时的嘎嘎声对死者家属的影响：不是声音本身，而是与他们感情的共鸣。
DOI：
10.1093/jjco/hyac055
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Miyashita M.
中科院分区：
文献类型：
--
作者：
Yamaguchi T;Mori M;Maeda I;Matsunuma R;Tanaka-Yagi Y;Nishi T;Kizawa Y;Tsuneto S;Shima Y;Masukawa K;Miyashita M.
背景本研究旨在探讨（i）医生评定的死亡声音强度与死者家属感知的死亡声音强度之间的一致性，（ii）死亡声音强度与死者家属痛苦之间的关系，以及（iii）死者家属与吸痰相关的经验和感受。日本。医生采用Back’s评分对临终声音的强度进行了前瞻性评估，并由死者家属进行了回顾性评估。结果共有1122名死者家属进行了回答（回答率：66.7%）。其中，297 例报告出现了临终声音。医生评估的临终咯咯声最大强度与死者家属感知的最大强度相关性较差（Spearman 相关系数 0.188，P= 0.082）。 Back得分检测高水平痛苦的最佳分界点是1/2，预测精度较低（曲线下面积0.62）。超过 70% 的死者家属表示，吸痰可以减轻临终时的嘎嘎声强度，使患者感到舒适，自己也得到缓解，而相似比例的患者则认为吸痰期间患者感到痛苦。感觉吸痰动作很轻柔，并与医疗保健提供者充分讨论是否进行吸痰的家庭感觉不太需要改进。 结论 失去亲人的家庭感知到的临终声音强度与医生评估的强度没有相关性，而且临死声音本身的强度似乎与家庭痛苦的相关性很小。在与家人充分讨论的基础上轻柔地进行吸痰有助于减少家人对患者的不适感。
BackgroundThis study aimed to explore (i) the consistency between physician-rated and bereaved family-perceived intensity of death rattle, (ii) the relationship between intensity of death rattle and the bereaved family’s distress and (iii) the bereaved family’s experience and feelings related to suctioning for death rattle.MethodsWe used matched data for deceased patients from a prospective cohort study of cancer patients admitted to a palliative care unit, and their bereaved families from a nationwide questionnaire survey in Japan. The intensity of death rattle using Back’s score was evaluated prospectively by physicians and retrospectively by bereaved families.ResultsIn total, 1122 bereaved families answered (response rate: 66.7%). Of these, 297 reported the development of death rattle. The maximum intensity of death rattle evaluated by physicians and perceived by bereaved families was poorly correlated (Spearman correlation coefficient 0.188,P= 0.082). The optimal cut-off point of Back’s score for detecting high-level distress was 1/2, with a low accuracy of prediction (area under the curve 0.62). More than 70% of bereaved families indicated suctioning reduced the intensity of death rattle, made patients comfortable and themselves relieved, whereas a similar proportion felt patients were in distress during suctioning. Families who felt suctioning was gently performed and discussed well whether to do suctioning with health care providers felt less needs for improvement.ConclusionsBereaved family-perceived intensity of death rattle did not correlate to physician-evaluated intensity, and the intensity of death rattle itself seemed to poorly correlate to family distress. Gently performed suctioning based on sufficient discussion with families can help reduce family-perceived patient discomfort.
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影响因子：
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作者：
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影响因子：
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作者：
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DOI：
10.1093/jjco/hyaa044
发表时间：
2020
期刊：
Jpn J Clin Oncol.
影响因子：
--
作者：
Matsunuma R;Suzuki K;Matsuda Y;Mori M;Watanabe H;Yamaguchi T.
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影响因子：
4.7
作者：
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