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首页> 外文期刊>Journal of palliative medicine >Trends of Do-Not-Resuscitate Orders, Hospice Care Utilization, and Late Referral to Hospice Care among Cancer Decedents in a Tertiary Hospital in Taiwan between 2008 and 2014: A Hospital-Based Observational Study
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Trends of Do-Not-Resuscitate Orders, Hospice Care Utilization, and Late Referral to Hospice Care among Cancer Decedents in a Tertiary Hospital in Taiwan between 2008 and 2014: A Hospital-Based Observational Study

机译：2008年至2014年间，Do-Not-respers，临界护理利用，临终关怀利用以及临界护理的临界护理趋势和晚期转诊：基于医院的观察研究

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Background: Out of respect for terminal patients' dignity and to decrease end-of-life suffering, patients in Taiwan can choose to sign do-not-resuscitate (DNR) orders and use hospice care when they are in a terminal condition. Objectives: To explore the trends and characteristics of hospice care utilization and DNR status among terminal cancer patients. Design and Setting/Subjects: A secondary data analysis was conducted to examine the rate of DNR orders, hospice care utilization, the survival time after DNR order, the duration of survival (DOS) after hospice care enrollment, and the rate of late referral to hospice care among patients who died from malignant cancers in a tertiary hospital in Taiwan between 2008 and 2014. Result: Of the 7857 patients, 7392 (94.1%) had signed a DNR order and 3965 (50.5%) had received hospice care. The rates of DNR orders and hospice care utilization were significantly different across sexes, cancer types, and admission departments (p<0.001). From 2008 through 2014, the overall hospice utilization rate grew from 39.9% to 57.9% (p<0.001), with increasing trends among most departments. The survival time after DNR order significantly increased (p<0.001), and the DOS showed no significant trend (p=0.404) but late referral rate increased from 29.4% to 35.7% (p=0.005). Conclusion: The hospice care utilization among terminal cancer patients increased in most specialty departments from 2008 through 2014. The DOS did not increase, but the rate of late referrals increased. Further research should be conducted to investigate the factors behind late referrals and non-growing DOS.
机译：背景：尊重终端患者的尊严和降低寿命痛苦，台湾的患者可以选择签署DO-NOT-RESUSCTITET（DNR）订单，并在终端状况时使用临终关怀护理。目的：探讨终末癌症患者的临终关怀利用和DNR状态的趋势和特点。设计和设定/主题：进行二级数据分析，以检查DNR订单，临终关乳病订单后的生存时间，临终关怀招待所（DOS）持续时间以及延迟转诊率的持续时间2008年至2014年间台湾第三级医院死于恶性癌症的患者中的临终关怀护理。结果：7857名患者，7392名（94.1％）签署了DNR订单，3965（50.5％）接受了临终关怀护理。 DNR订单和临终关怀护理利用率的利率在性别，癌症类型和入场部门有显着差异（P <0.001）。从2008年到2014年，整体临终关怀利用率从39.9％增加到57.9％（P <0.001），大多数部门的趋势越来越大。 DNR命令显着增加（P <0.001）后的存活时间（P <0.001）显示没有显着趋势（P = 0.404），但晚期转诊率从29.4％增加到35.7％（P = 0.005）。结论：从2008年至2014年，终末癌症患者的临界护理利用率在大多数专业部门增加。DOS没有增加，但晚期推荐的速度增加。应进行进一步的研究，以调查晚期推荐和非生长DOS背后的因素。

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