某安寧病房病人死亡準備時間之回溯性研究

A Retrospective Study of Dying Preparation Time between Patients in A Hospice Ward

10.6537/TJHPC.2016.21(3).5

張舜欽(Shun-Chin Chang)；孔睦寰(Mu-Huan Koung)；林名男(Ming-Nan Lin)

末期病人 ； 死亡準備 ； 臨終照護 ； terminal patients ； dying preparation ； end of life care

安寧療護雜誌

21卷3期（2016 / 11 / 01）

304 - 315

繁體中文

研究目的：本研究旨在了解安寧病房中病人被告知死亡準備到實際死亡的時間相差多久，與其疾病不同是否有差異。材料與方法：採病歷回溯性調查，研究對象為2013年1 月至2015 年12 月從本院安寧病房死亡之病人。收集病人相關基本資料與特性(包含性別、年齡、診斷、住院天數)，及「告知死亡準備日期」到「實際死亡日期」的時間。研究結果：共計收集455 位病人，平均死亡準備時間為6.1±7.8(0~54)天。在癌症病人中，頭頸部癌平均死亡準備時間10.5 天為最長，其次為婦女泌尿生殖系統癌(7.6 天)。非癌症病人則以腦部疾患(含中風及重度失智) 11.5 天為最長。大多數病人(75%)的死亡準備時間≦7 天；其餘病人(25%)的死亡準備時間＞7 天，其中以頭頸部癌、婦女泌尿生殖系統癌經由百分比Z 檢定與Bonferroni 校正法後與其他病人相比有統計上意義(p＜0.05)。結論：頭頸部癌症、婦女泌尿生殖系統癌症與腦部疾患(含中風及重度失智)病人有較長的死亡準備時間。未來需要更多的研究探討影響各種疾病死亡準備時間長短的因子，以供臨床參考用。

Background: Dying preparation is very important component of terminal care, and many studies indicates that well preparation for dying patients may influence psychiatric outcomes such as complicated grief and major depression disorder among bereaved care givers. Purpose: The purpose of study is to understand the dying preparation time between patients with different disease in hospice ward. Material and Method: A retrospective medical review was conducted at the hospice ward in Dalin Tzuchi Hospital from January 2013 to December 2015. There were total of 455 patients in the study who expired at hospice ward or were discharged due to terminal condition. Results: Of the 455 patients, 436(95.82%) patients had dying preparation. The average time of dying preparation in those patients is 6.1 days. In cancer patients, patients with head and neck cancer had longest dying preparation (10.5 days), follow by female urogenital cancer (7.6 days). In non-cancer patients, patients with CNS disorders (including old CVA and dementia) had longest dying preparation (11.5 days). Conclusion: There were different dying preparation time between patients in hospice ward, which was longer in patients with head and neck cancer, female urogenital cancer and CNS disorders. Future research is needed to identify other factors influencing dying preparation time.

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