Age, gender, will, and use of home-visit nursing care are critical factors in home care for malignant diseases; a retrospective study involving 346 patients in Japan
| Autor: | Hideki Ohta, Satoshi Hirahara, Shigeru Onozawa, Yukiyasu Nakamura, Shohei Kawagoe, Takuhiro Yamaguchi, Morihito Takita, Tadashi Wada, Tomoko Matsumura, Yukihiro Kimura, Hiroshi Suzuki, Kazushi Nakano, Masahiro Kami, Koichiro Yuji, Yuko Kodama |
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| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Medicine(all)
Pediatrics medicine.medical_specialty Palliative care Performance status business.industry Medical record lcsh:RC952-1245 Hazard ratio lcsh:Special situations and conditions Retrospective cohort study complication General Medicine medicine.disease Confidence interval palliative medicine Nursing care medicine Dementia cancer performance status business Research Article dementia |
| Zdroj: | BMC Palliative Care, Vol 10, Iss 1, p 17 (2011) BMC Palliative Care |
| Popis: | Background We aimed to clarify the factors affecting outcomes of home care for patients with malignant diseases. Methods Of 607 patients who were treated in 10 clinics specialized in home care between January and December 2007 at Chiba, Fukuoka, Iwate, Kagoshima, Tochigi and Tokyo prefectures across Japan, 346 (57%; 145 men and 201 women) had malignant diseases. We collected information on medical and social backgrounds, details of home care, and its outcomes based on their medical records. Results Median age of the patients was 77 years (range, 11-102), and 335 patients were economically self-sufficient. Their general condition was poor; advanced cancer (n = 308), performance status of 3-4 (n = 261), and dementia (n = 121). At the beginning of home care, 143 patients and 174 family members expressed their wish to die at home. All the patients received supportive treatments including fluid replacement and oxygenation. Median duration of home care was 47 days (range, 0-2,712). 224 patients died at home. For the remaining 122, home care was terminated due to complications (n = 109), change of attending physicians (n = 8), and others (n = 5). The factors which inhibited the continuity of home care were the non-use of home-visit nursing care (hazard ratio [HR] = 1.78, 95% confidence interval [CI]: 1.05-3.00, p = 0.03), the fact that the patients themselves do not wish to die at home (HR = 1.83, CI: 1.09-3.07, p = 0.02), women (HR = 1.81, CI: 1.11-2.94, p = 0.02), and age (HR = 0.98, CI: 0.97-1.00, p = 0.02). Conclusions Continuation of home care is influenced by patients' age, gender, will, and use of home-visit nursing. |
| Databáze: | OpenAIRE |
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