Is good 'quality of life' possible at the end of life? An explorative study of the experiences of a group of cancer patients in two different care cultures.
Is good 'quality of life' possible at the end of life? An explorative study of the experiences of a group of cancer patients in two different care cultures.
复制标题
在生命的尽头有可能获得良好的“生活质量”吗？
DOI：
10.1046/j.1365-2702.2001.00511.x
复制
发表时间：
2001
影响因子：
4.2
通讯作者：
J. Johansson
中科院分区：
文献类型：
--
作者：
E. Sahlberg‐Blom;B. Ternestedt;J. Johansson
本研究旨在探讨一群重症病患在不同照护文化下，如何评估其生命最后一个月的生活质量。研究材料包括47名癌症患者的生活质量评估，这些评估是在他们生命的最后一个月完成的。两个生活质量问卷，EORTC QLQ-C30和社会心理健康问卷，被使用。这些数据是按照各自调查表的说明处理的，结果主要以平均数的形式提出，大多数是在组一级。两种不同的护理文化，护理导向和治疗导向的患者的评估进行了比较。结果显示，尽管在许多方面的生活质量都比一般人低，但一些患者在生命的最后一个月里经历了幸福和满意。“认知功能”和“情感功能”是与普通人群差异最小的维度，“身体功能”，“角色功能”和“整体健康状况/生活质量”差异最大。“疲劳”显示症状量表/项目的最高平均值。有一种倾向，在治疗为导向的护理文化，报告更多的症状比那些在护理为导向的护理文化。一个例外是“疼痛”，这是更经常报告的那些在护理为导向的护理文化。从不同的角度讨论了结果的含义。知识的意义，病人如何体验他们的生活质量进行了讨论方面的护理和规划的护理垂死的病人。
The purpose of this paper was to explore how a group of gravely ill patients, cared for in different care cultures, assessed their quality of life during their last month of life. The study material comprised quality of life assessments from 47 cancer patients, completed during their last month of life. Two quality of life questionnaires, the EORTC QLQ-C30 and a psychosocial well-being questionnaire, were used. The data were treated in accordance with instructions for the respective questionnaires, and the results are presented primarily as means, mostly at the group level. Assessments from patients in two different care cultures, care-orientated and cure-orientated, were compared. The results show that despite having an assessed lower quality of life in many dimensions than people in general, several patients experienced happiness and satisfaction during their last month of life. 'Cognitive functioning' and 'emotional functioning' were the dimensions that differed least from those of the general population, and 'physical functioning', 'role functioning' and 'global health status/quality of life' differed the most. 'Fatigue' showed the highest mean for the symptom scales/items. There was a tendency for those cared for in the cure-orientated care culture to report more symptoms than those in the care-orientated care culture. An exception to this was 'pain', which was reported more often by those in the care-orientated care culture. The implications of the results are discussed from different angles. The significance of knowledge concerning how patients experience their quality of life is also discussed with respect to the care and the planning of care for dying patients.