农村终末期癌症患者临终关怀调查分析

An analysis of hospice care for terminal cancer patients in countryside

目的了解农村终末期癌症患者临终关怀现状,分析影响患者生存质量的主要因素,改善患者的生存质量。方法采用便利抽样法,对2014年简阳各乡镇2350例农村肿瘤患者中的306例终末期患者进行抽样,抽取183例,设计包含临床疾病特征、基本生活条件(如经济条件、医疗保险)、对临终关怀认知度和接受度、卫生服务需求(如止痛)、生存质量等主要元素的问卷调查表,进行实地调查。结果农村终末期癌症患者年龄普遍较大、文化程度较低、人均收入较低、分期较晚,大多数患者有伴随症状,对临终关怀的认知度低(32.79%),58.46%(107例)患者愿意接受临终关怀,10.38%(19例)不愿意接受。对我院医务人员初步实施的临终关怀满意度比较高,总的满意率达92.90%。结论农村终末期癌症患者因为文化程度和经济条件等原因对临终关怀认知度和接受度均较低,癌性疼痛及其他伴随症状得不到及时处置,需要医务人员或临终关怀机构的专业指导,更需要引起社会的关注并制定有效的措施改善该类患者的生存质量。

Objective To understand the status of hospice care for rural terminal cancer patients, to analyze the main factors affecting the quality of survival and to provide the reference for improving the quality of the patients. Methods Convenience sampling method was used to investigate the terminal cancer patients in the countryside of Jianyang city in 2014. The questionnaire survey was carried out on-the-spot including clinical pathologic features, the basic living conditions such as economic conditions, recognition and acceptance to the hospice care and quality of life （QOL）. Results Among 183 cases extracted, most of the patients were the eiders with poor educational and income. Most of the patients had symptoms such as pain. The recognition to hospice care was low （32. 79% ）. There were 58.46% （ 107 cases） of patients willing to accept the hospice care and 10. 38 % （ 19 cases） not. Preliminary implementation of hospice care of our staffs was satisfactory with 92. 90% of total satisfactory rate. Conclusion Rural terminal patients with tumor need professional hospice care because of the cultural degree, economic conditions and weakness education or related profes- sional guidance. The problems need to draw more social attentions and make effective measures to improve their QOL.