https://scholars.lib.ntu.edu.tw/handle/123456789/545056
標題: | Factors affecting the improvement of quality of dying of terminally ill patients with cancer through palliative care: A ten-year experience | 作者: | SHAO-YI CHENG Dy S. WEN-YU HU Chen C.-Y. TAI-YUAN CHIU |
公開日期: | 2012 | 卷: | 15 | 期: | 8 | 起(迄)頁: | 854-862 | 來源出版物: | Journal of Palliative Medicine | 摘要: | Background: Achieving a good death is the ultimate goal of palliative medicine. Yet, very few studies have investigated factors affecting improvement in quality of dying. We therefore conducted a study to evaluate these factors in terminally ill Taiwanese cancer patients treated in a multidisciplinary palliative care unit. Methods: We included data from terminally ill patients with cancer admitted to the Hospice and Palliative Care Unit in the National Taiwan University Hospital from 2000 to 2009. Quality of dying was assessed by patients' multidisciplinary team at admission and after death using the Good Death Scale and the Audit Scale. We used multivariable regression to assess the association between patient factors, including gender, age, diagnosis, days of hospitalization, calendar year of admission, Good Death score at admission, and process of care scores for physical care, physician-assessed autonomy, emotional support, communication, continuity of life, and physician-reported rate of closure, with the quality of dying. Results: Multivariate regression analysis identified lower Good Death score at admission, lower age 40-65 years, longer unit length of stay (>7 days), higher physician-assessed autonomy, better physician-assessed emotional support, and better physician-reported rate of closure as positively related (all p<0.0001) with improvement in good death scores. Conclusion: In this study in a Taiwanese palliative care unit; we found that late referral to the unit and low physician-assessed autonomy were key factors negatively affecting quality of dying. Earlier truth-tellling and end-of-life care discussions between physicians and patients might improve the quality of dying in this population. ? Copyright 2012, Mary Ann Liebert, Inc. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84864582229&doi=10.1089%2fjpm.2012.0033&partnerID=40&md5=470e0da67d01d954b0b4834f16280d58 https://scholars.lib.ntu.edu.tw/handle/123456789/545056 |
ISSN: | 1096-6218 | DOI: | 10.1089/jpm.2012.0033 | SDG/關鍵字: | adult; aged; article; cancer palliative therapy; cancer patient; dying; female; hospice care; hospital admission; hospitalization; human; length of stay; major clinical study; male; patient care; posthumous care; scoring system; Taiwan; terminally ill patient; total quality management; Adolescent; Adult; Age Factors; Aged; Child; Female; Humans; Length of Stay; Male; Middle Aged; Multivariate Analysis; Neoplasms; Palliative Care; Personal Autonomy; Prospective Studies; Quality of Life; Social Support; Taiwan; Terminally Ill; Young Adult |
顯示於: | 醫學系 |
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