RESUMO
A survey was conducted from April through September, 1997, of 24 hospitalized terminal lung cancer patients connected to IVH and CSC, for whom the possibility of release from hospital was considered, and of their families. A comparative survey was made between patients who accepted HIT and those who did not. No difference was found between the groups by age, sex, or disease stage, nor was there a difference in physical symptoms such as pain and respiratory difficulty. However, the percentage of patients who were told the name of their disease was significantly higher in the group switched to HIT, 3 of whom were even given prognoses. There was no difference in the percentage of patients who lived with their families, although there was a higher percentage in the HIT group whose spouses also lived with the family. Nineteen of the 24 patients wished to return home, but 8 of those patients were not released from hospital for such reasons as the patient not wanting to be a burden on his or her family or the family's lack of ability to provide care. It was found that important factors in urging home care for the terminal cancer patient were whether or not the patient was told the name of his or her disease, and whether or not the patient lived with a healthy spouse.
Assuntos
Serviços Hospitalares de Assistência Domiciliar , Terapia por Infusões no Domicílio , Neoplasias Pulmonares/terapia , Idoso , Feminino , Humanos , Masculino , Assistência Terminal , Falha de TratamentoRESUMO
To improve the quality of life in cancer patients at a near-terminal stage, we assisted patients to stay home using a system for home infusion therapy (HIT) established at Osaka Prefectural Habikino Hospital in 1994. From April in 1995 to April in 1996, 25 patients were treated at home using the HIT system for longer than 7 days. Thirteen out of 25 patients still stayed at home even at a terminal stage and died in their residences. There was no difference either in the mean age or in the HIT duration between 13 patients who died at home and the remaining 12 patients who were readmitted to their hospitals before death. However, 47% of the patients who died at home had been told their diagnoses by doctors and realized their own prognoses, while only 17% of the patients who died in the hospital knew their diagnoses and prognoses. Seventy-seven percent of the patients who died at home were given home oxygen therapy (HOT), against 33% of the patients who died in the hospital. Furthermore, the patients who died at home were given more intensive care than the patients who died in the hospital, because the former had a larger family than the latter. In conclusion, HIT at a near-terminal stage and death at home may be more readily accepted by patients who know their diagnoses and prognoses and have a large family.
Assuntos
Terapia por Infusões no Domicílio , Neoplasias/terapia , Assistência Terminal , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude Frente a Morte , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/enfermagem , Neoplasias/psicologia , Inquéritos e QuestionáriosRESUMO
To improve the quality of life in patients with malignant diseases at the near-terminal stage, we established a system for home infusion therapy (HIT) in Osaka Prefectural Habikino Hospital in 1994. Thirty-three patients were taken care of at home using the HIT system from January, 1995 to May, 1996. Their average age was 70 years old. The duration of HIT varied from 1 to 105 days (mean:25.5 days). Twenty-four cases received parenteral nutrition. The others received agents for brain edema (4 cases), morphine hydrochloride (2 cases), and anti-fungal agents (3 case). Additionally, 63% of these patients required home oxygen therapy (HOT) with HIT. Questionnaires to their families revealed that they were afraid of the progress of the disease in patients and their physical burden became heavier after the start of HIT. However, they were quite satisfied with the results of HIT.