Araştırma Makalesi
Yıl 2020,
Cilt: 5 Sayı: 3, 90 - 94, 24.11.2020
Öz
Introduction: Palliative care centers (PC centers) provide multidisciplinary care for patients with multiple comorbid conditions. This study aimed to assess and compare patients’ diagnoses, length of hospital stays, and demographic data and coordination with home health care services.
Methods: This is a descriptive, cross-sectional and retrospective study. Patients who were hospitalized in PC centers of secondary and tertiary care hospitals between 01.08.2018 and 01.08.2018 were retrospectively assessed. Patients’ demographic characteristics diagnoses of hospitalization, and length of hospital stays and centers where they received treatment were recorded.
Results: Median age of 830 patients included in the study was 79 (24-102). Out of 830 patients, 48.9% were male and 51.1% were female. Mean length of hospital stay was 14 days and median length was 8.7 (0.6-112) days. The three most common comorbid diseases followed up were malignancy (21.8%), cerebrovascular disease (15.2%) and malaise-fatigue-senility (10.7%). The group with Alzheimer's disease was the oldest patient group. The group with nutritional deficiency-malnutrition was the patient group with the longest hospital stay (p=0.030). The number of patients who were hospitalized for cerebrovascular diseases was the highest in secondary care centers and the number of patients who were hospitalized for malignancy was the highest in tertiary care centers. Patients hospitalized in secondary PC center were older. The hospital stays were longer in tertiary PC center. Patients receiving treatment at a tertiary PC center had a significantly higher rate of mortality. The number of patients who were discharged was lower in the tertiary PC centers. Hospitalization to a secondary PC center through home care units was significantly higher.
Conclusion: In this study, the rate and diagnoses of hospitalization and length of hospital stays were different in secondary and tertiary PC centers. Our study has made an assessment about palliative care centers at various levels of health care and can be considered as prior knowledge for other studies.
Anahtar Kelimeler
Palliative care alzheimer disease neoplasms fatigue cerebrovascular disorders malnutrition
Kaynakça
- 1. Busolo D, Woodgate R. Palliative care experiences of adult cancer patients from ethnocultural groups: a qualitative systematic review protocol. JBI Database System Rev Implement Rep 2015;13(1):99-111. https://doi.org/10.11124/jbisrir-2015-1809
- 2. Voumard R, Rubli Truchard E, Benaroyo L, Borasio GD, Büla C, Jox RJ. Geriatric palliative care: a view of its concept, challenges and strategies. BMC Geriatr 2018;18(1):220. https://doi.org/10.1186/s12877-018-0914-0
- 3. Sepulveda C, Marlin A, Yoshida T, Ullrich A. Palliative care: The world health organization’s global perspective. J Pain Symptom Manage 2002;24(2):91-6. https://doi.org/10.1016/s0885-3924(02)00440-2
- 4. WHO Definition of Palliative Care, World Health Organization, 2002. Available at: http://www.who.int/cancer/palliative/definition/en/ (Access Date: June 16, 2020)
- 5. Yuruyen M, Tevetoglu IO, Tekmen Y, Polat O, Arslan I, Okuturlar Y. [Prognostic factors and clinical features in palliative care patients] (in Turkish). Konuralp Med J 2018;10(1):74-80. https://doi.org/10.18521/ktd.368570
- 6. Uslu FS, Terzioglu F. [Palliative Care Education and Organization in the World and Turkey] (in Turkish). Cumhuriyet J Nurs 2015;4(2):81-90.
- 7. Kahveci K, Dincer M, Doger C, Yarici AK. Traumatic brain injury and palliative care: A retrospective analysis of 49 patients receiving palliative care during 2013-2016 in Turkey. Neural Regen Res 2017;12:77–83. https://doi.org/10.4103/1673-5374.198987
- 8. Benli AR, Sunay D. [A model of collaboration between palliative care unit and home health care services: Karabuk] (in Turkish). Ankara Med J 2017;17(3):143-50. https://doi.org/10.17098/amj.33933
- 9. Regulation on home care services presentation. Presidential official journal of the republic of Turkey. Available at: https://www.resmigazete.gov.tr/eskiler/2005/03/20050310-5.htm (Access Date: June 15, 2020)
- 10. Onder T, Anuk T, Kahramanca S,Yildirim AC. [Evaluating sociodemographic and medical conditions of patients under home care service] (in Turkish). Dicle Med J 2015;42(3):342-5. https://doi.org/10.5798/diclemedj.0921.2015.03.0586
- 11. Ozalp G, Uysal N, Oguz G, Kocak N, Karaca S, Kadiogullari N. Identification of symptom clusters in cancer patients at palliative care clinic. Asia-Pacific J Oncol Nurs 2017;4(3):259-64. https://doi.org/10.4103/apjon.apjon_17_17
- 12. Uysal N, Senel G, Karaca S, Kadiogullari N, Kocak N, Oguz G. [Symptoms seen in inpatient palliative care and impact of palliative care unit on symptom control] (in Turkish). Agri 2015;27(2):104–10. https://doi.org/10.5505/agri.2015.26214
- 13. Akdogan D, Kahveci K. Evalution of geriatric infections in palliative care center. Turk Geriatr J 2018;21:507–14. https://doi.org/10.31086/tjgeri.2018.55
Yıl 2020,
Cilt: 5 Sayı: 3, 90 - 94, 24.11.2020
Öz
Giriş: Palyatif bakım merkezleri (PBM) çoklu komorbid durumlari bulunan hastalara multidisipliner bakım veren merkezlerdir. Bu çalışmamızda PBM’nde tedavi gören hastaların tanıları, yatış süreleri, demografik verileri ve evde sağlık hizmetleri ile koordinasyonunu değerlendirip karşılaştırmayı amaçladık.
Yöntem: Tanımlayıcı, kesitsel, retrospektif tipte bir çalışmadır. İkinci ve üçüncü basamak hastanelerin, PBM’de 01.08.2018 ile 01.03.2020 tarihleri arasında yatan hastalar retrospektif olarak değerlendirildi. Hastaların demografik özellikleri, yatış tanıları, yatış süreleri, tedavi gördüğü merkezler kaydedildi.
Bulgular: Çalışmaya dahil edilen 830 hastanın yaş ortancası 79 (24-102) du. Hastaların %48,9’u erkek, %51,1’i kadın hastaydı. Yatış süresi ortalaması 14, ortancası 8,7 (0,6-112) gündü. En sık takip edilen üç komorbid hastalık kanser (%21,8), serebrovasküler hastalık (%15,2) ve kırgınlık, yorgunluk-yaşlılık (%10,7) idi. Alzheimer hastalığı grubu en yaşlı bakım alan hasta grubunu oluşturmaktaydı. Beslenme eksikliği-malnütrisyon en uzun süre yatan hasta grubuydu. İkinci basamak merkezde daha fazla kişi serebrovasküler hastalıklardan, üçüncü basamak PBM‘de kanser hastalıklarından daha fazla kişi yatarak tedavi almıştı. İkinci basamak PBM’de yatan hastalar daha yaşlıdır. Üçüncü basamak PBM’ de ise yatış süresi daha uzundur. Üçüncü basamak PBM’de tedavi alan hastaların exitus oranı daha yüksekti. Üçüncü basamak PBM’den taburcu olan hasta sayısı daha azdı. İkinci basamak PBM’ye evde sağlık birimi üzerinden yatış daha fazlaydı.
Sonuç: Bu çalışmada ikinci ve üçüncü Basamak PBM’leri arasında yatış oranları, tanıları ve süreleri farklılık göstermiştir. Çalışmamız çeşitli basamaklarda bulunan palyatif bakım merkezleri hakkında durum tespiti yapmış olup başka çalışmaların yapılması konusunda önbilgi niteliğinde değerlendirilebilir.
Anahtar Kelimeler
Palyatif bakım alzheimer hastalığı malignite kırgınlık serebrovasküler hastalıklar malnütrisyon
Kaynakça
- 1. Busolo D, Woodgate R. Palliative care experiences of adult cancer patients from ethnocultural groups: a qualitative systematic review protocol. JBI Database System Rev Implement Rep 2015;13(1):99-111. https://doi.org/10.11124/jbisrir-2015-1809
- 2. Voumard R, Rubli Truchard E, Benaroyo L, Borasio GD, Büla C, Jox RJ. Geriatric palliative care: a view of its concept, challenges and strategies. BMC Geriatr 2018;18(1):220. https://doi.org/10.1186/s12877-018-0914-0
- 3. Sepulveda C, Marlin A, Yoshida T, Ullrich A. Palliative care: The world health organization’s global perspective. J Pain Symptom Manage 2002;24(2):91-6. https://doi.org/10.1016/s0885-3924(02)00440-2
- 4. WHO Definition of Palliative Care, World Health Organization, 2002. Available at: http://www.who.int/cancer/palliative/definition/en/ (Access Date: June 16, 2020)
- 5. Yuruyen M, Tevetoglu IO, Tekmen Y, Polat O, Arslan I, Okuturlar Y. [Prognostic factors and clinical features in palliative care patients] (in Turkish). Konuralp Med J 2018;10(1):74-80. https://doi.org/10.18521/ktd.368570
- 6. Uslu FS, Terzioglu F. [Palliative Care Education and Organization in the World and Turkey] (in Turkish). Cumhuriyet J Nurs 2015;4(2):81-90.
- 7. Kahveci K, Dincer M, Doger C, Yarici AK. Traumatic brain injury and palliative care: A retrospective analysis of 49 patients receiving palliative care during 2013-2016 in Turkey. Neural Regen Res 2017;12:77–83. https://doi.org/10.4103/1673-5374.198987
- 8. Benli AR, Sunay D. [A model of collaboration between palliative care unit and home health care services: Karabuk] (in Turkish). Ankara Med J 2017;17(3):143-50. https://doi.org/10.17098/amj.33933
- 9. Regulation on home care services presentation. Presidential official journal of the republic of Turkey. Available at: https://www.resmigazete.gov.tr/eskiler/2005/03/20050310-5.htm (Access Date: June 15, 2020)
- 10. Onder T, Anuk T, Kahramanca S,Yildirim AC. [Evaluating sociodemographic and medical conditions of patients under home care service] (in Turkish). Dicle Med J 2015;42(3):342-5. https://doi.org/10.5798/diclemedj.0921.2015.03.0586
- 11. Ozalp G, Uysal N, Oguz G, Kocak N, Karaca S, Kadiogullari N. Identification of symptom clusters in cancer patients at palliative care clinic. Asia-Pacific J Oncol Nurs 2017;4(3):259-64. https://doi.org/10.4103/apjon.apjon_17_17
- 12. Uysal N, Senel G, Karaca S, Kadiogullari N, Kocak N, Oguz G. [Symptoms seen in inpatient palliative care and impact of palliative care unit on symptom control] (in Turkish). Agri 2015;27(2):104–10. https://doi.org/10.5505/agri.2015.26214
- 13. Akdogan D, Kahveci K. Evalution of geriatric infections in palliative care center. Turk Geriatr J 2018;21:507–14. https://doi.org/10.31086/tjgeri.2018.55
Toplam 13 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi (Original Article) |
| Yazarlar | |
| Yayımlanma Tarihi | 24 Kasım 2020 |
| Gönderilme Tarihi | 17 Haziran 2020 |
| Kabul Tarihi | 21 Aralık 2020 |
| Yayımlandığı Sayı | Yıl 2020Cilt: 5 Sayı: 3 |