4.2 Article

Care complexity and place of death in palliative home care

期刊

GACETA SANITARIA
卷 37, 期 -, 页码 -

出版社

ELSEVIER
DOI: 10.1016/j.gaceta.2022.102266

关键词

Palliative care; Needs assessment; Home care services; Attitude to death; Advance care planning

向作者/读者索取更多资源

This study examined the associations between the dimensions of the HexCom care complexity model and the place of death. The results showed that a greater functional impairment, being male, being over 80 years old, and the presence of care complexity in the last days were associated with a higher likelihood of dying at home. On the other hand, having cancer, poor external support, feeling at peace with others, and lack of agreement on the planning of the place of death were associated with a lower likelihood of dying at home.
Objective: To examine the associations between the dimensions of the HexCom care complexity model and the place of death.Method: Multicenter longitudinal observational study in patients with advanced illness cared for by home care support teams in Catalonia. Age, gender, type of illness, main caregiver, external support, place of death and the sub-areas of care complexity provided by HexCom were registered. A multivariate Cox regression analysis was performed.Results: Participation of 1527 patients (72% oncology), cared for a median of 35 days. 45% died at home. The probability of dying at home was greater when a greater functional impairment was detected in the initial assessment (hazard ratio [HR]: 7.67; 95% confidence interval [95%CI]: 4.93-11.92), when the patient was male (HR: 1.19; 95%CI: 1.02-1.39), was over 80 years old (HR: 1.41; 95%CI: 1.20-1.66) and when care complexity was detected in relation to being in a situation of last days (HR: 2.24; 95%CI: 1.69-2.97). It was more likely not to die at home in the case of cancer (HR: 0.76; 95%CI: 0.64-0.89), or if poor external support to the family group was detected in the first evaluation (HR: 0.79; 95%CI: 0.67-0.93), or that the patient did not feel at peace with others (HR: 0.56; 95%CI: 0.40-0.79), or lack of agreement on the planning of the place of death (HR: 0.57; 95%CI: 0.48-0.68).Conclusions: The assessment of the complexity of care through the HexCom-Clin model can help to improve advance planning of decisions by incorporating among its dimensions the feeling of peace with others, the external support to the family nucleus and the degree of agreement on the place of death.(c) 2022 SESPAS. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.2
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据