Study on the factors determining home death of patients during home care: A historical cohort study at a home care support clinic
Study on the factors determining home death of patients during home care: A historical cohort study at a home care support clinic
复制标题
DOI：
10.1111/ggi.12018
复制
发表时间：
2013-10-01
影响因子：
3.3
通讯作者：
Doi, Hiroyuki
中科院分区：
文献类型：
--
作者：
Kawagoe, Seiji;Tsuda, Toshihide;Doi, Hiroyuki
AimAssociation之间的显着低的日常生活活动（ADL）在开始家访护理和患者的家庭死亡进行了分析，从家庭护理支持诊所在日本，有一个低的家庭deaths.MethodsThe研究的数据是一个历史性的队列研究。它涉及的患者在2006年4月1日至2011年3月31日期间开始接受家访护理支持诊所的家访护理。使用家庭死亡作为因变量，存在/不存在显著低ADL和其他参数（癌症、患者希望家庭死亡等）作为独立变量，调整后的危险比和95%置信区间（CI）计算使用的考克斯比例hazardsmodel. ResultsMarkly低ADL与家庭死亡，即使调整后的因素，影响家庭死亡（调整后的危险比4.40，95%CI 2.37-8.16）。癌症和病人希望在家中死亡是统计学上显著的因素。在根据有无癌症进行的亚组分析中，无癌症组中明显低ADL与家庭死亡之间的关联更强（校正风险比10.78; 95% CI 2.89-40.26）（调整后的风险比5.58;结论家庭护理支持诊所不仅为晚期癌症患者提供家庭访视服务，还包括卧床不起的无癌患者。我们必须建立制度，让老年人在生命的最后阶段留在家里。Geriatr Gerontol Int 2012; 13：874-880.
AimAssociations between markedly low activities of daily living (ADL) at the start of home visit care and patient home death were analyzed using data from a home care support clinic in Japan that has a low rate of home deaths.MethodsThe study was a historical cohort study. It involved patients who began to receive home visit care from a home visit care support clinic between 1 April 2006 and 31 March 2011. Using home death as a dependent variable and presence/absence of markedly low ADL and other parameters (cancer, the patient's desire for home death, etc.) as independent variables, the adjusted hazard ratio and 95% confidence interval (CI) were calculated using the Cox proportional hazards model.ResultsMarkedly low ADL were associated with home death even after adjustment for factors that influence home death (adjusted hazard ratio 4.40; 95% CI 2.37-8.16). Cancer and the patient's desire for home death were statistically significant factors involved in home death. In a subgroup analysis according to the presence/absence of cancer, the association between markedly low ADL and home death was stronger in the cancer-free group (adjusted hazard ratio 10.78; 95% CI 2.89-40.26) than in the cancer group (adjusted hazard ratio 5.58; 95% CI2.39-13.05).ConclusionPatients' desire for home death could be fulfilled if home care support clinics provide home visit services to not only terminal-stage cancer patients, but also bedridden cancer-free patients. We must establish systems for older adults to remain at home during the terminal period of their lives. Geriatr Gerontol Int 2012; 13: 874-880.