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首页> 外文期刊>Journal of palliative medicine >Predictors of intensive end-of-life and hospice care in latino and white advanced cancer patients
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Predictors of intensive end-of-life and hospice care in latino and white advanced cancer patients

机译：拉丁美洲人和白人晚期癌症患者的临终关怀和临终关怀护理的预测指标

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Background: The role of end-of-life (EOL) care preferences and conversations in receipt of care near death for Latinos is unclear. Objective: This study examines rates and predictors of intensive EOL and hospice care among Latino and white advanced cancer patients. Design: Two-hundred-and-ninety-two self-reported Latino (n=58) and white (n=234) Stage IV cancer patients participated in a U.S. multisite, prospective, cohort study from September 2002 to August 2008. The Latino and white, non-Hispanic participants were interviewed and followed until death, a median of 118.5 days from baseline. Measurements: Patient-reported, baseline predictors of EOL care included EOL care preference; terminal illness acknowledgement; EOL discussion; completion of a DNR order; and religious coping. Caregiver postmortem interviews provided information regarding EOL care received. Intensive EOL care was defined as resuscitation and/or ventilation followed by death in an intensive care unit. Hospice was either in- or outpatient. Results: Latino and white patients received intensive EOL and hospice care at similar rates (5.2% and 3.4% for intensive care, p=0.88; 70.7% versus 73.4% for hospice, p=0.33). No white or Latino patient who reported a DNR order or EOL discussion at baseline received intensive EOL care. Religious coping and a preference for life-extending care predicted intensive EOL care for white patients (adjusted odds ratio [aOR] 6.69 [p=0.02] and aOR 6.63 [p=0.01], respectively), but not for Latinos. No predictors were associated with Latino hospice care. Conclusions: EOL discussions and DNR orders may prevent intensive EOL care among Latino cancer patients. Efforts should continue to engage Latino patients and caregivers in these activities.
机译：背景：对于拉丁美洲人来说，临终护理偏好和谈话在临终护理中的作用尚不清楚。目的：本研究检查了拉丁美洲和白人晚期癌症患者中强化EOL和临终关怀护理的发生率和预测指标。设计：2002年9月至2009年间，有292例自我报告的拉丁美洲人（n = 58）和白人患者（n = 234）参加了一项美国多中心，前瞻性队列研究。对非西班牙裔白人和白人参与者进行了采访，直到死亡为止，中位数距离基线118.5天。测量：患者报告的EOL护理基线预测指标包括EOL护理偏好;绝症确认;停产讨论;完成DNR订单;和宗教应对。照顾者事后访谈提供了有关已接受EOL照顾的信息。重症EOL护理的定义是在重症监护室进行复苏和/或通气，然后死亡。临终关怀是住院或门诊。结果：拉丁裔和白人患者接受重度EOL和临终关怀的比率相似（重症监护分别为5.2％和3.4％，p = 0.88;临终关怀的比例为73.4％，p = 0.33）为70.7％。基线时未报告DNR订单或EOL讨论的白人或拉丁裔患者均未接受强化EOL护理。宗教应对和偏爱延长寿命的护理可预测白人患者将接受强化EOL护理（调整后的优势比[aOR] 6.69 [p = 0.02]和aOR 6.63 [p = 0.01]），但拉美裔则没有。没有预测因素与拉丁裔临终关怀护理相关。结论：EOL讨论和DNR命令可能会阻止拉丁美洲裔癌症患者进行深入的EOL护理。应继续努力使拉丁裔患者和护理人员参与这些活动。

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