WONCA研究论文摘要汇编——初级医疗患者自愿停止饮食加速死亡

发布时间：2018-04-02 22:30

本文选题：家庭医生　切入点：问卷回收率　出处：《中国全科医学》2015年31期

【摘要】：目的患者有时候会采取自愿停止饮食(VSED)的方式有意加速死亡,在这种情况下家庭医生所起到的作用鲜为人知。本研究旨在为遇到此类情况的家庭医生提供更多信息,对医生VSED的参与情况、患者的特点和动机、VSED持续时间和进程以及患者生命最后3 d的一般症状进行描述。方法从全国范围内随机选取1 100名家庭医生进行调查(问卷回收率为72%),对其中500名医生提出关于最近一次遇到VSED情况的问题。结果符合条件医生有978名,其中708名(72.4%)予以回答;曾经护理VSED加速死亡患者的医生占46%。在500名回答额外问题的医生中,符合条件的为440名,其中285名(64.8%)予以回答,共描述了99名VSED患者。在收集的患者资料中,70%的患者年龄为80岁以上,76%的患者患有严重疾病(27%患有癌症),77%的患者需依赖他人进行日常护理。患者选择加速死亡的原因通常是身体老化(79%)、存在严重疾病(77%)和依赖别人(58%)。死亡前中位时间为7 d,死亡前的一般症状为疼痛、疲劳、认知功能受损、口渴或者喉咽干燥。在62%的VSED案例中有家庭医生参与。结论通过VSED加速死亡的患者多数身体状况差。家庭医生可以应对VSED,他们帮助患者了解VSED,在VSED期间为患者提供帮助和症状管理,在此类患者的护理中起到了重要作用。
[Abstract]:Objective patients sometimes voluntarily stop eating VSED) to deliberately accelerate death, in which case the role of family doctors is little-known.The purpose of this study was to provide more information for family doctors who encountered such situations, to describe the participation of doctors in VSED, the duration and process of the patients and the general symptoms of the last 3 days of their lives.Methods A total of 1 100 family doctors were randomly selected from all over the country.Results there were 978 qualified doctors, 708 of whom answered 72.4%, 46 doctors who had cared for patients with accelerated death of VSED.Of the 500 doctors who answered additional questions, 440 were eligible, 285 of whom answered 64.8, and 99 VSED patients were described.Among the collected data, 70% of the patients were over 80 years old and 76% had serious diseases. 27% of the patients had cancer and 77% of the patients had to rely on others for daily nursing.The reason patients choose to accelerate death is usually due to aging, serious illness, and dependence on others.The median time before death was 7 days. The common symptoms before death were pain, fatigue, impaired cognitive function, thirst or dry throat.Family doctors were involved in 62% of VSED cases.Conclusion most patients with accelerated death through VSED are in poor physical condition.Family doctors can deal with VSED, helping patients understand VSED, providing help and symptom management during VSED, and playing an important role in the care of such patients.
【分类号】：R473

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