期刊
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
卷 39, 期 3, 页码 591-604出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jpainsymman.2009.07.007
关键词
Place of death; decision making; terminal care; palliative care; systematic review
资金
- John A. Hartford Foundation Center of Excellence in Geriatrics, University of Hawaii
- National Center for Research Resources, National Institutes of Health [1 R25 RR019321]
- NATIONAL CENTER FOR RESEARCH RESOURCES [R25RR019321] Funding Source: NIH RePORTER
Congruence between preferred and actual place of death may be an essential component in terminal care. Most patients prefer a home death, but many patients do not die in their Preferred location. Specialized (physician, hospice, and palliative) home care visits may increase home deaths, but factors associated with congruence have not been systematically reviewed. This study sought to review the extent of congruence reported in the literature and examine factors that may influence congruence. In July 2009, a comprehensive literature search was performed using MEDLINE, PsychInfo, CINAHL, and Web of Science. Reference lists, related articles, and the past five years of six palliative care journals were also searched. Overall congruence rates (percentage of met preferences for all locations of death) were calculated for each study using reported data to allow cross-study comparison. Eighteen articles described 30%-91% congruence. Eight specialized home care studies reported 59%-91% congruence. A physician-led home care program reported 91% congruence. Of the 10 studies without specialized home care for all patients, seven reported 56%-71% congruence and most reported unique care programs. Of the remaining three studies without specialized home care for all patients, two reported 43%-46% congruence among hospital inpatients, and one elicited patient preference if everything were possible, with 30% congruence. Physician support, hospice enrollment, and family support improved congruence in multiple studies. Research in this important area must consider potential sources of bias, the method of eliciting patient preference, and the absence of a single ideal place of death. J Pain Symptom Manage 2010;39:591-604. (C) 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
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