目的 调查晚期癌症患者居家安宁疗护服务照护问题及需求现况,并分析其影响因素.方法 采用便利抽样法,选取2022年11月-2023年4月上海市某三甲医院住院确诊晚期癌症并符合安宁疗护服务准入条件的430例患者为研究对象,采用一般资料调查表在患者住院期间收集其基本信息,居家期间对其采用修订后中文版居家安宁疗护问题与需求问卷(problems and needs in palliative care questionnaire short version,PNPC-sv)进行横断面调查,并通过单因素、多元线性回归等方法分析其影响因素.结果 共纳入424例患者,居家安宁疗护问题总得分为8.00(4.00,14.00)分,身体症状、居家自我照护与经济问题得分分别为3.00(0.00,6.00)、1.00(0.00,4.00)和0.00(0.00,3.00)分.居家安宁疗护需求总得分为8.00(4.00,13.75)分,身体症状、居家自我照护与经济问题需求得分分别为3.00(0.00,6.00)、1.00(0.00,4.00)和0.00(0.00,2.00)分.多元线性回归分析结果显示:癌症类型、医疗付费方式、健康状况和经济来源是晚期癌症患者居家安宁疗护问题的主要影响因素,癌症类型、健康状况、经济来源与患者居家安宁疗护需求具有相关性(P＜0.05).结论 晚期癌症患者面临较多的居家安宁疗护问题与需求,主要集中在症状控制、居家自我照护和经济压力方面;自评健康状况、经济来源和癌症类型为主要影响因素.未来可加大社区安宁疗护人力和医疗资源配置,建立完善的筹资机制和医保制度,为居家安宁疗护服务开展提供资源和制度保障.
Investigation of the problems and needs of home-based hospice care for advanced cancer patients and analysis of its influencing factors
Objective To investigate the problems and needs of home-based hospice care in patients with advanced cancer,and to analyze its influencing factors.Methods A total of 430 patients diagnosed with advanced cancer and eli-gible for hospice access in a Grade A hospital in Shanghai from November 2022 to April 2023 were selected by the convenience sampling method,and the general information questionnaire was used to collect their basic information during hospitalization,and a cross-sectional survey was conducted using a revised Chinese version of problems and needs in palliative care questionnaire short version(PNPC-sv)during the home period,and the influencing factors were analyzed by means of univariate and multivariate linear regressions.Results A total of 424 patients were en-rolled,with a total home hospice problem score of 8.00(4.00,14.00)points,and physical symptom,home self-care,and financial problem scores of 3.00(0.00,6.00)points,1.00(0.00,4.00)points,and 0.00(0.00,3.00)points,respectively.The total home hospice need score was 8.00(4.00,13.75)points,and the scores of physical symptom,home self-care,and financial problem need were 3.00(0.00,6.00)points,1.00(0.00,4.00)points,and 0.00(0.00,2.00)points,respectively.The results of the multiple linear regression analysis showed that cancer type,medical payment method,health status,and financial source were the main factors influencing the home hos-pice care problems of patients with advanced cancer,and that cancer type,health status,and financial source were significantly correlated with the patients need for home hospice care(P＜0.05).Conclusion Patients with advanced cancer face high levels of home-based hospice problems and needs,centered on symptom control,home self-care,and financial stress.Self-rated health status,financial support,and types of cancer were the main influencing fac-tors.In the future,it is necessary to increase the allocation of community hospice manpower and medical resources,establish a perfect financing mechanism and health insurance system,and provide resources and institutional guaran-tee for the development of home hospice services.
万方数据
维普
