Abstract：
BACKGROUND: Artificial hydration (AH) is a challenging issue in terminally ill patients with cancer, because it influences patients\' symptoms control, quality of life, and quality of dying (QOD). To date, it is not clear how much AH supply is proper for imminently dying patients. This study aimed to investigate the association between the amount of AH and QOD.
METHODS: This study is part of the East Asian Collaborative Cross-Cultural Study to Elucidate the Dying Process (EASED) conducted in Japan, Korea, and Taiwan from January 2017 to September 2018. Patients\' demographics, symptoms, and managements on admission to palliative care units (PCUs) and before death were recorded. The AH amount was classified into different groups by 250-mL intervals to compare their difference. The Good Death Scale (GDS) was used to measure QOD, with patients classified into higher or lower QOD groups using GDS = 12 as the cutoff point. We used logistic regression analysis to assess the association between AH amount and QOD.
RESULTS: In total, 1530 patients were included in the analysis. Country, religion, spiritual well-being, fatigue, delirium, dyspnea, AH, and antibiotics use before death were significantly associated with QOD. After conducting regression analysis, patients administered with 250 to 499 mL AH had significantly better QOD (odds ratio, 2.251; 95% confidence interval, 1.072-4.730; P = .032) than those without AH.
CONCLUSIONS: AH use impacts the QOD of terminally ill patients with cancer admitted to PCUs. Communication with patients and their families on appropriate AH use has a positive effect on QOD.
BACKGROUND: Our prospective cross-cultural multicenter study aims to investigate the relationship between artificial hydration (AH) amount and quality of dying among terminally ill patients with cancer. The findings reveal that country, religion, spiritual well-being, fatigue, delirium, dyspnea, AH, and antibiotics use before death were significantly associated with quality of death (QOD). After multivariable logistic regression, patients administered with AH amount 250 to 499 mL had significantly better QOD (odds ratio, 2.251; 95% confidence interval, 1.072-4.730; P = .032) than those without AH. Communication with patients and their families regarding AH is recommended as it may help them be better prepared for the end-of-life stage and achieve a good death.
METHODS: This study is part of the East Asian Collaborative Cross-Cultural Study to Elucidate the Dying Process (EASED) conducted in Japan, Korea, and Taiwan from January 2017 to September 2018. Patients\' demographics, symptoms, and managements on admission to palliative care units (PCUs) and before death were recorded. The AH amount was classified into different groups by 250-mL intervals to compare their difference. The Good Death Scale (GDS) was used to measure QOD, with patients classified into higher or lower QOD groups using GDS = 12 as the cutoff point. We used logistic regression analysis to assess the association between AH amount and QOD.
RESULTS: In total, 1530 patients were included in the analysis. Country, religion, spiritual well-being, fatigue, delirium, dyspnea, AH, and antibiotics use before death were significantly associated with QOD. After conducting regression analysis, patients administered with 250 to 499 mL AH had significantly better QOD (odds ratio, 2.251; 95% confidence interval, 1.072-4.730; P = .032) than those without AH.
CONCLUSIONS: AH use impacts the QOD of terminally ill patients with cancer admitted to PCUs. Communication with patients and their families on appropriate AH use has a positive effect on QOD.
BACKGROUND: Our prospective cross-cultural multicenter study aims to investigate the relationship between artificial hydration (AH) amount and quality of dying among terminally ill patients with cancer. The findings reveal that country, religion, spiritual well-being, fatigue, delirium, dyspnea, AH, and antibiotics use before death were significantly associated with quality of death (QOD). After multivariable logistic regression, patients administered with AH amount 250 to 499 mL had significantly better QOD (odds ratio, 2.251; 95% confidence interval, 1.072-4.730; P = .032) than those without AH. Communication with patients and their families regarding AH is recommended as it may help them be better prepared for the end-of-life stage and achieve a good death.
摘要：
背景：在患有癌症的绝症患者中，人工水化（AH）是一个具有挑战性的问题，因为它会影响患者的症状控制，生活质量,和染色质量（QOD）。迄今为止,目前尚不清楚有多少AH供应适合即将死亡的患者。本研究旨在探讨AH量与QOD之间的关系。
方法：这项研究是在日本进行的东亚合作跨文化研究（EASED）的一部分，韩国,和台湾从2017年1月到2018年9月。患者人口统计学，症状,记录姑息治疗单位(PCU)入院时和死亡前的管理情况.以250-mL的间隔将AH量分为不同的组，以比较它们的差异。良好死亡量表(GDS)用于测量QOD，使用GDS=12作为截止点将患者分为QOD较高或较低的组。我们使用逻辑回归分析来评估AH量与QOD之间的关联。
结果：总计，1530名患者被纳入分析。国家,宗教,精神上的幸福，疲劳,谵妄,呼吸困难,啊,死亡前使用抗生素与QOD显著相关。在进行回归分析后，给予250至499mLAH的患者QOD明显更好（比值比，2.251；95%置信区间，1.072-4.730；P=.032）比没有AH的
结论：AH使用会影响接受PCU的癌症绝症患者的QOD。与患者及其家属沟通适当使用AH对QOD有积极影响。
背景：我们的前瞻性跨文化多中心研究旨在调查绝症癌症患者的人工水合（AH）量与死亡质量之间的关系。调查结果显示，这个国家，宗教,精神上的幸福，疲劳,谵妄,呼吸困难,啊,死亡前使用抗生素与死亡质量（QOD）显著相关。经过多变量逻辑回归，AH剂量为250至499mL的患者QOD明显更好（比值比，2.251；95%置信区间，1.072-4.730；P=.032）比没有AH的建议与患者及其家人就AH进行沟通，因为这可能有助于他们为生命终结阶段做好准备并获得良好的死亡。
方法：这项研究是在日本进行的东亚合作跨文化研究（EASED）的一部分，韩国,和台湾从2017年1月到2018年9月。患者人口统计学，症状,记录姑息治疗单位(PCU)入院时和死亡前的管理情况.以250-mL的间隔将AH量分为不同的组，以比较它们的差异。良好死亡量表(GDS)用于测量QOD，使用GDS=12作为截止点将患者分为QOD较高或较低的组。我们使用逻辑回归分析来评估AH量与QOD之间的关联。
结果：总计，1530名患者被纳入分析。国家,宗教,精神上的幸福，疲劳,谵妄,呼吸困难,啊,死亡前使用抗生素与QOD显著相关。在进行回归分析后，给予250至499mLAH的患者QOD明显更好（比值比，2.251；95%置信区间，1.072-4.730；P=.032）比没有AH的
结论：AH使用会影响接受PCU的癌症绝症患者的QOD。与患者及其家属沟通适当使用AH对QOD有积极影响。
背景：我们的前瞻性跨文化多中心研究旨在调查绝症癌症患者的人工水合（AH）量与死亡质量之间的关系。调查结果显示，这个国家，宗教,精神上的幸福，疲劳,谵妄,呼吸困难,啊,死亡前使用抗生素与死亡质量（QOD）显著相关。经过多变量逻辑回归，AH剂量为250至499mL的患者QOD明显更好（比值比，2.251；95%置信区间，1.072-4.730；P=.032）比没有AH的建议与患者及其家人就AH进行沟通，因为这可能有助于他们为生命终结阶段做好准备并获得良好的死亡。
