PDF(Pubmed)
Abstract：
UNASSIGNED: Variation in the provision of care and outcomes in the last months of life by cancer and non-cancer conditions is poorly understood.
UNASSIGNED: (1) To describe patient conditions, symptom burden, practical problems, service use and dissatisfaction with end-of-life care for older adults based on the cause of death. (2) To explore factors related to these variables focussing on the causes of death.
UNASSIGNED: Secondary analysis of pooled data using cross-sectional mortality follow-back surveys from three studies: QUALYCARE; OPTCare Elderly; and International Access, Right, and Empowerment 1.
UNASSIGNED: Data reported by bereaved relatives of people aged ⩾75 years who died of cancer, cardiovascular disease, respiratory disease, dementia or neurological disease.
UNASSIGNED: The pooled dataset contained 885 responses. Overall, service use and circumstances surrounding death differed significantly across causes of death. Bereaved relatives reported symptom severity from moderate to overwhelming in over 30% of cases for all causes of death. Across all causes of death, 28%-38% of bereaved relatives reported some level of dissatisfaction with care. Patients with cardiovascular disease and dementia experienced lower symptom burden and dissatisfaction than those with cancer. The absence of a reliable key health professional was consistently associated with higher symptom burden (p = 0.002), practical problems (p = 0.001) and dissatisfaction with care (p = 0.001).
UNASSIGNED: We showed different trajectories towards death depending on cause. Improving symptom burden and satisfaction in patients at the end-of-life is challenging, and the presence of a reliable key health professional may be helpful.
UNASSIGNED: (1) To describe patient conditions, symptom burden, practical problems, service use and dissatisfaction with end-of-life care for older adults based on the cause of death. (2) To explore factors related to these variables focussing on the causes of death.
UNASSIGNED: Secondary analysis of pooled data using cross-sectional mortality follow-back surveys from three studies: QUALYCARE; OPTCare Elderly; and International Access, Right, and Empowerment 1.
UNASSIGNED: Data reported by bereaved relatives of people aged ⩾75 years who died of cancer, cardiovascular disease, respiratory disease, dementia or neurological disease.
UNASSIGNED: The pooled dataset contained 885 responses. Overall, service use and circumstances surrounding death differed significantly across causes of death. Bereaved relatives reported symptom severity from moderate to overwhelming in over 30% of cases for all causes of death. Across all causes of death, 28%-38% of bereaved relatives reported some level of dissatisfaction with care. Patients with cardiovascular disease and dementia experienced lower symptom burden and dissatisfaction than those with cancer. The absence of a reliable key health professional was consistently associated with higher symptom burden (p = 0.002), practical problems (p = 0.001) and dissatisfaction with care (p = 0.001).
UNASSIGNED: We showed different trajectories towards death depending on cause. Improving symptom burden and satisfaction in patients at the end-of-life is challenging, and the presence of a reliable key health professional may be helpful.
摘要：
■在生命的最后几个月中，癌症和非癌症疾病在提供护理和结果方面的差异知之甚少。
■(1)描述病人的情况，症状负担，实际问题,基于死亡原因的服务使用和对老年人临终关怀的不满。(2)探讨与这些变量相关的死亡原因。
■使用来自三项研究的横断面死亡率随访调查对汇总数据进行二次分析：QUALYCARE；OPTCare老年人；和国际访问，对,赋权1。
■由75岁死于癌症的人失去亲人的亲属报告的数据，心血管疾病,呼吸道疾病,痴呆或神经系统疾病。
■合并的数据集包含885个响应。总的来说,不同死亡原因的服务使用和死亡环境差异显著。失去亲人的亲属报告说，在所有死亡原因的30％以上的病例中，症状严重程度从中度到压倒性。在所有死亡原因中，28%-38%的丧亲亲属报告对护理有一定程度的不满。心血管疾病和痴呆症患者的症状负担和不满低于癌症患者。缺乏可靠的关键卫生专业人员始终与较高的症状负担相关（p=0.002），实际问题(p=0.001)和对护理的不满(p=0.001)。
■我们显示了不同的死亡轨迹，取决于原因。改善患者临终时的症状负担和满意度是具有挑战性的，一个可靠的关键卫生专业人员的存在可能会有所帮助。
■(1)描述病人的情况，症状负担，实际问题,基于死亡原因的服务使用和对老年人临终关怀的不满。(2)探讨与这些变量相关的死亡原因。
■使用来自三项研究的横断面死亡率随访调查对汇总数据进行二次分析：QUALYCARE；OPTCare老年人；和国际访问，对,赋权1。
■由75岁死于癌症的人失去亲人的亲属报告的数据，心血管疾病,呼吸道疾病,痴呆或神经系统疾病。
■合并的数据集包含885个响应。总的来说,不同死亡原因的服务使用和死亡环境差异显著。失去亲人的亲属报告说，在所有死亡原因的30％以上的病例中，症状严重程度从中度到压倒性。在所有死亡原因中，28%-38%的丧亲亲属报告对护理有一定程度的不满。心血管疾病和痴呆症患者的症状负担和不满低于癌症患者。缺乏可靠的关键卫生专业人员始终与较高的症状负担相关（p=0.002），实际问题(p=0.001)和对护理的不满(p=0.001)。
■我们显示了不同的死亡轨迹，取决于原因。改善患者临终时的症状负担和满意度是具有挑战性的，一个可靠的关键卫生专业人员的存在可能会有所帮助。
