There are many deaths occurring among the aged population in Japan. Geriatric Health Service Facilities (GHSFs) are highlighted as some of the chosen facilities designated as sites of death. The aim of our study was t...There are many deaths occurring among the aged population in Japan. Geriatric Health Service Facilities (GHSFs) are highlighted as some of the chosen facilities designated as sites of death. The aim of our study was to clarify the characteristics and related factors, including physical signs first noticed by staff at the end-of-life period, in GHSFs designated as sites of death, using a nationwide survey in Japan. We administered a questionnaire to 3971 GHSFs in Japan. Eligible responses for the study were obtained from 854 GHSFs. We found that GHSFs designated as sites of death were more likely to have basic policies and documented preferences regarding end-of-life care. We also found that staff members in GHSFs designated as sites of death were less likely to first notice physical signs of pain. We found that GHSFs designated as sites of death tended to identify earlier symptoms, such as reduced oral intake and less vigor. Our results would enable elderly persons, their families, and staff in GHSFs to prepare for the elderly’s death more efficiently though earlier identification of the end-of-life period. We hope that GHSFs have an important role to play in end-of-life care provision to elderly persons in Japan, through the strengthening of these intermediate facilities.展开更多
目的评价终末期肾病行高通量血透治疗的预后效果,为终末期肾病患者治疗工作提供参考。方法选择我院2018年8月至2019年6月期间收治治疗的终末期肾病患者,总计80例。结合血透治疗方案进行随机法分组,对照组、观察组例数一致,伦理委员会审...目的评价终末期肾病行高通量血透治疗的预后效果,为终末期肾病患者治疗工作提供参考。方法选择我院2018年8月至2019年6月期间收治治疗的终末期肾病患者,总计80例。结合血透治疗方案进行随机法分组,对照组、观察组例数一致,伦理委员会审核批准。对照组40例终末期肾病患者行低通量血透治疗,观察组40例终末期肾病患者行高通量血透治疗,比较两组患者的治疗情况,包括并发症发生情况、血清学指标、降压药使用频率以及生活质量状况,参考健康调查简表(The MOS Item Short from Health Survey,SF-36)评估。结果就并发症情况分析,观察组患者高甲状腺血症、肾性骨病等并发症发生率5.00%明显低于对照组(20.00%),P<0.05;就β_(2)-微球蛋白、血红蛋白、血磷以及甲状旁腺素相关指标水平比较,治疗后比较治疗前改善,观察组β_(2)-微球蛋白(41.02±6.60)mg/L、血磷(1.73±0.33)μmol/L、甲状旁腺素(248.02±10.02)μmol/L均低于对照组,血红蛋白(114.20±9.20)g/L高于对照组,P<0.05;就降压药使用频率分析,观察组降压药使用频率7.50%明显低于对照组的25.00%,P<0.05;就生活质量评分进行分析,观察组患者评分高于对照组,P<0.05。结论对比低通量血透治疗,高通量血透治疗终末期肾病的效果显著,利于缓解和改善症状体征,且安全性获得保障,提高了患者的生活质量。展开更多
文摘There are many deaths occurring among the aged population in Japan. Geriatric Health Service Facilities (GHSFs) are highlighted as some of the chosen facilities designated as sites of death. The aim of our study was to clarify the characteristics and related factors, including physical signs first noticed by staff at the end-of-life period, in GHSFs designated as sites of death, using a nationwide survey in Japan. We administered a questionnaire to 3971 GHSFs in Japan. Eligible responses for the study were obtained from 854 GHSFs. We found that GHSFs designated as sites of death were more likely to have basic policies and documented preferences regarding end-of-life care. We also found that staff members in GHSFs designated as sites of death were less likely to first notice physical signs of pain. We found that GHSFs designated as sites of death tended to identify earlier symptoms, such as reduced oral intake and less vigor. Our results would enable elderly persons, their families, and staff in GHSFs to prepare for the elderly’s death more efficiently though earlier identification of the end-of-life period. We hope that GHSFs have an important role to play in end-of-life care provision to elderly persons in Japan, through the strengthening of these intermediate facilities.
文摘目的评价终末期肾病行高通量血透治疗的预后效果,为终末期肾病患者治疗工作提供参考。方法选择我院2018年8月至2019年6月期间收治治疗的终末期肾病患者,总计80例。结合血透治疗方案进行随机法分组,对照组、观察组例数一致,伦理委员会审核批准。对照组40例终末期肾病患者行低通量血透治疗,观察组40例终末期肾病患者行高通量血透治疗,比较两组患者的治疗情况,包括并发症发生情况、血清学指标、降压药使用频率以及生活质量状况,参考健康调查简表(The MOS Item Short from Health Survey,SF-36)评估。结果就并发症情况分析,观察组患者高甲状腺血症、肾性骨病等并发症发生率5.00%明显低于对照组(20.00%),P<0.05;就β_(2)-微球蛋白、血红蛋白、血磷以及甲状旁腺素相关指标水平比较,治疗后比较治疗前改善,观察组β_(2)-微球蛋白(41.02±6.60)mg/L、血磷(1.73±0.33)μmol/L、甲状旁腺素(248.02±10.02)μmol/L均低于对照组,血红蛋白(114.20±9.20)g/L高于对照组,P<0.05;就降压药使用频率分析,观察组降压药使用频率7.50%明显低于对照组的25.00%,P<0.05;就生活质量评分进行分析,观察组患者评分高于对照组,P<0.05。结论对比低通量血透治疗,高通量血透治疗终末期肾病的效果显著,利于缓解和改善症状体征,且安全性获得保障,提高了患者的生活质量。
文摘目的评估变应原特异性免疫治疗(specific immunotherapy,SIT)对常规方法症状控制不满意的难治性变应性鼻炎(AR)患者症状和生活质量的影响。方法选取螨过敏的常年性AR患者47例,经过常规避开螨、药物治疗效果不佳后进行变应原SIT,使用鼻部症状总评分(total nasal symptoms scores,TNSS)问卷和鼻结膜炎相关生活质量问卷(rhinoconjunctivitis quality of life questionnaire,RQLQ),在治疗前,治疗后3、6、12个月时分别评估患者症状和生活质量。结果 TNSS总分和各症状评分、RQLQ总评分及各分项评分在治疗前,治疗后3、6、12个月的评分均有不同程度降低。相关分析显示TNSS评分同RQLQ总分之间呈正相关。结论常规方法控制无效的螨过敏AR患者的症状和生活质量经过变应原SIT后有着明显提高,治疗后3个月已经开始有效,随着治疗的时间延长,疗效进一步提高。
