[Elderly outpatients' attitudes toward care in terminal stage disease].
[Elderly outpatients' attitudes toward care in terminal stage disease].
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老年门诊患者对末期疾病护理的态度[J].
DOI：
10.3143/geriatrics.36.45
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
T. Ozawa
中科院分区：
文献类型：
--
作者：
S. Matsushita;T. Inamatsu;H. Hashimoto;R. Takahashi;T. Takahashi;M. Mori;K. Kida;T. Ozawa
从562名门诊患者（73.4 +/- 8.6岁：平均值+/- SD，男性：女性= 1.0：1.7）中获得了对关于1）在家中死亡，2）被告知癌症诊断，3）水化和营养，使用麻醉剂治疗疼痛和呼吸困难，氧气治疗，抗生素，输血和手术的调查问卷的答复。64%的人倾向于在家中死亡，24%的人倾向于在医院死亡。分别有60%和65%的患者选择在疾病的最后3个月或早期可治愈阶段被告知诊断，而只有53%的患者希望被准确告知他们剩余的估计生存期。如果他们的配偶患有晚期疾病，42%的人选择将诊断结果告知配偶。80%的人选择姑息治疗，而9.3%的人希望接受强化生命维持治疗。在接近植物人的情况下，8.7%的患者需要管饲，39%的患者需要静脉滴注，40%和52%的患者需要麻醉剂来缓解疼痛或呼吸困难，56%和11%的患者分别选择氧气或气管切开术加呼吸机来缓解呼吸困难，38%的患者需要抗生素治疗感染，36%的患者需要手术治疗肠梗阻，因出血而输血者占29%;在任何情况下不接受治疗者占21%。通常表达的愿望是自然死亡，死在家里，并被告知他们的疾病状况，而姑息治疗的细节没有得到很好的认识。
Responses to a questionnaire regarding 1) dying at home, 2) being told of a diagnosis of cancer, and 3) hydration and nutrition, uses of narcotics for pain and dyspnea, oxygen treatment, antibiotics, transfusion and surgery in a near-vegetative state was obtained from 562 outpatients (73.4 +/- 8.6 years:mean +/- SD, men:women = 1.0:1.7). Dying at home was preferred by 64% and hospital death by 24%. Sixty and 65% of patients chose to be told of the diagnosis either in the last 3 months or at the early curable stage of the disease respectively, while only 53% wanted to be told precisely about their remaining estimated survival. If their spouse had terminal stage disease, 42% chose to inform the spouse of the diagnosis. Eighty percent chose palliative care, while 9.3% wished for intensive life-sustaining treatment. In a near vegetative state, tube feeding was desired by 8.7% and intravenous drip infusion by 39%; narcotics for pain or dyspnea were desired by 40 and 52%; oxygen or tracheostomy plus a respirator for dyspnea was chosen in 56 and 11% respectively; antibiotics for treatment of infection was desired by 38%; surgery for intestinal obstruction by 36 percent; transfusion for bleeding by 29%; and no treatment in any situation by 21%. Commonly expressed wishes were for a natural death, dying at home, and being told of the status of their disease, while details of palliative care were not well recognized.