影響安寧居家護理病人在宅往生之因素

Factors Associated with Home Death in Patients under Hospice Home Care

10.6537/TJHPC.202009_24(3).02

陳儀倩(Yi-Chien Chen)；黃智玉(Chin-Yu Huang)；林碧莉(Pi-Li Lin)

安寧居家護理 ； 在宅往生 ； 善終 ； hospice home care ； home death ； good death

安寧療護雜誌

24卷3期（2020 / 09 / 01）

209 - 224

繁體中文

安寧居家護理是目前先進國家正視的議題，也是達成病人在宅往生的重要推手。本文旨在探討影響安寧居家護理病人之在宅往生因素。採病歷回顧法，收集2014年11月至2017年11月接受花蓮縣南區某醫院附設居家護理所之安寧居家護理病人，登錄病人的基本人口學資料、家訪公里數、往生地點、病人表達在宅往生意願及家屬期待善終地等進行資料收集。本研究共有117位病人納入分析，運用SPSS for windows 21.0統計分析，採用描述性統計及卡方檢定進行分析。研究發現，僅12.8%已預立醫囑，影響安寧居家護理病人在宅往生之因素，分別為家訪公里數、家屬期待善終地、收案7日內（含）死亡與臨終訪視。本研究得知影響安寧居家護理病人在宅往生之因素，提供臨床醫護人員參考，並適時地提供相關的照護，以期家屬可安心在宅照顧，病人也能夠在宅善終。

Hospice home care is the eventful issue in developed countries, which is also the important driving force for home death of terminal patients. The purpose of this study was to explore the factors of home death for patients receiving hospice home care. This retrospective study enrolled patients with terminal diseases who were receiving hospice home care in south Hualien during the period from November 2014 to November 2017. Data was collected from medical records including demographic data, distance from hospital to patients' home, the place of death, the willing of patients about home death and the expectation of family about the place of good death. There were 117 participants included, and SPSS for windows 21.0 was used for data analysis. Data were analyzed by using descriptive statistics and chi-square test. In this current study, only 12.8% patients had advanced directive (AD). The influences factors of home death of the patients under hospice home care were distance between home and hospital, the expectation of family about the place of good death, death within 7 days of receiving home hospice care and pre-dying home visiting. This study disclosed the factors influencing home death of the patients under hospice home care and provided the reference for clinical medical members, and expected that the family can be comfortable for home death and the patients can own good death.

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