It will have a big impact on the mental health of the family who dies at the hospital or dies at home, or where the place to spend the last days is left



Cancer (cancer)In a survey targeting those who die and those who take care of them,ICU (intensive care unit)Patient who dies at home got at homeHome Terminal CareCompared with patients who died while receivingQOL (Quality of Life)It is clear that it is low.

This may be a natural result if you think about how to care for home terminal with a primary focus on improving QOL, but the place of death may not only affect the patient himself but also the mental health of the bereaved family It is known. Bereaved families of cancer patients who died at home compared with the bereaved families of patients who died at the hospital,PTSD (Posttraumatic Stress Disorder)It is said that probability of becoming 1/5 will be.

Details are as below.Study Finds Where Patients Die Affects Quality Of Life And Mental Health Of Caregivers

"The place where cancer patients die will be very important not only for themselves but also for the family who is nursing.The results of this study show that efforts to reduce the number of patients who die at hospitals and to disseminate home hospices will be the end of the patient It also suggests that they may improve the quality of life and alleviate the risk of family members suffering from psychiatric disorders as a response to death.Harvard Medical SchoolWhenDana-Farber Cancer InstituteAlexi A. Wright medical doctor who is a lecturer and a lead author of this paper.

Dr. Wright et al. Studied about the patient's QOL and the mental health of the patient for 342 advanced cancer patients and those who take care of it. Patient is the period from study participation to death (Median4.5 months) Follow-up and as soon as the patient died, Dr. Wright et al. Evaluated the quality of life for two weeks immediately before death. For nurses, mental health status was assessed at the time of participation in the study and six months after the patient died.

As a result, it was found that it is very important for both the patient and the nurse to know where to spend their final days. Patients who died in the hospital room or ICU had greater physical and mental distress than the patients at home hospice and had poor quality of life and families who were nursing also had a case of death at home when a patient died at a hospital It seems that the risk of becoming PTSD was 5 times higher.

Specifically, 21% of the bereaved families nursing patients who died in the hospital developed PTSD, while 4.4% in the case of bereaved families who died at home. Also, the proportion at which Prolonged Grief Disorder (Prolonged Grief Disorder), a strong long grief that would make it hard to get anything else, was 21.6% for the bereaved families of patients who died at the hospital, whereas the proportion of deaths at home The patient 's bereaved family was 5.2%.

Researchers anticipated that the patient's own quality of life would be affected by the last days of their lives, but it is unlikely that such a large impact on the mental health of the bereaved family in the process of mourning the patient's death It is said that it was unexpected. The result of this study is the first time that a patient's postmortem nurse has shown an association between the risk of suffering from mental illness and the place of death of the patient.

Dr. Wright et al. Proposed several measures to reduce the number of patients who choose to die in a hospital, including discussing "how to finish life" between physicians, patients and nurses and improving patient education I am proposing.

"If you know the impact of your treatment and what kind of treatment you are going to have in the last days and the impact on your QOL and the impact on those who will leave behind, Some patients may make different choices such as expressing their intentions, "Dr. Wright says.

From now on,prognosisDoes the patient and doctor fully understand aboutchemical treatmentDr. Wright said that "About 70% of patients with advanced cancer are going to be involved in cancer treatment," said Dr. Wright, who is planning to investigate the communication and decision-making between patients and physicians, I want to know the prognosis, but only one-third of the terminal patient reports that I am aware that I am dying.If the patient is well informed about my prognosis, If you are understanding the low possibility of reacting to you, do you make a different choice and give different results? We want to explore it. "

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