Factors Associated With Mode of Separation for People With Palliative Diagnoses With Preference for Home Death Receiving Care From a Nurse-Led End of Life (Palliative Extended and Care at Home) Program

被引:2
作者
Agar, Meera [1 ,2 ,3 ]
Xuan, Wei [4 ,5 ]
Lee, Jessica [6 ,7 ]
Barclay, Greg [8 ]
Oloffs, Alan [9 ]
Jobburn, Kim [10 ]
Harlum, Janeane [11 ]
Maurya, Nutan [12 ]
Chow, Josephine Sau Fan [13 ,14 ,15 ,16 ,17 ,18 ,19 ]
机构
[1] Univ Technol Sydney, Fac Hlth, Palliat Med, Sydney, NSW, Australia
[2] Univ Technol Sydney, Fac Hlth, Sydney, NSW, Australia
[3] South West Sydney Local Hlth Dist, Liverpool, Australia
[4] Ingham Inst, Liverpool, Australia
[5] Univ New South Wales, SWS Clin Sch, Liverpool, Australia
[6] Concord Repatriat Gen Hosp, Concord Ctr Palliat Care, Sydney, Australia
[7] Univ Sydney, Concord Clin Sch, Sydney, NSW, Australia
[8] Illawarra Shoalhaven Local Hlth Dist, Palliat Care Serv, Warrawong, NSW, Australia
[9] Nepean Blue Mt Local Hlth Dist, Nepean Hosp, Nepean Canc Ctr, Support & Palliat Care, Penrith, Australia
[10] South Western Sydney Local Hlth Dist, Strateg Programs, Clin Innovat & Business Unit, Liverpool, NSW, Australia
[11] South Western Sydney Local Hlth Dist, Dist Palliat Care Serv, Liverpool, NSW, Australia
[12] South Western Sydney Local Hlth Dist, Clin Innovat & Business Unit, Liverpool, NSW, Australia
[13] South Western Sydney Local Hlth Dist, Clin Innovat & Business Unit, Strategy & Partnerships, Liverpool, Australia
[14] Ingham Inst, Nursing & Midwifery, Res Alliance, Liverpool, Australia
[15] South Western Sydney Local Hlth Dist, Res, Liverpool, Australia
[16] Univ New South Wales, Fac Med, Sydney, Australia
[17] Univ Sydney, Sydney, NSW, Australia
[18] Univ Tasmania, Sch Hlth Sci, Hobart, Australia
[19] South Western Sydney Local Hlth Dist, Liverpool Hosp, Clin Innovat & Business Unit, Clin Streams Off, Don Everett Bldg Level 1,BC 1871, Liverpool Bc, NSW 1871, Australia
关键词
demographic and clinical predictors; home death; nurse-led package; palliative care; PEACH; AUSTRALIAN CASEMIX CLASSIFICATION;
D O I
10.1097/NJH.0000000000000841
中图分类号
R47 [护理学];
学科分类号
1011 ;
摘要
Palliative Extended and Care at Home (PEACH) is a rapid response nurse-led package of care mobilized for palliative care patients who have an expressed preference to die at home. This study aimed to identify the demographic and clinical predictors of home death for patients receiving the package. Deidentified data were used from administrative and clinical information systems. Univariate and multivariate analyses were conducted to assess association of sociodemographic factors with mode of separation. Furthermore, 1754 clients received the PEACH package during the study period. Mode of separation was home death (75.7%), hospital/palliative care unit admission (13.5%), and alive/discharged from the PEACH Program (10.8%). Of participants with clear preference to die at home, 79% met their wish. Multivariate analysis demonstrated cancer diagnosis, patients who wished to be admitted when death was imminent, and patients with undecided preference for location of death were associated with an increased likelihood of being admitted to the hospital. Compared with those with spousal caregivers, those cared for by their child/grandchild and other nonspouse caregivers were significantly associated with a decreased likelihood of being admitted to the hospital/palliative care unit. Our results show that opportunities to tailor home care based on referral characteristics to meet patient preference to die at home, at individual, system, and policy levels, exist.
引用
收藏
页码:215 / 223
页数:9
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