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남은정 ( Nam Eun-Jeong ) - 국립암센터 호스피스완화의료실
이세나 ( Lee Se-Na ) - 국립암센터 간호본부
이란 ( Lee Ran ) - 국립암센터 간호본부
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Abstract
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Purpose: The purpose of this study was to compare the differences in the performance of life-sustaining treatment after signing a do-not-resuscitate (DNR) order between terminal cancer patients who died in the cancer unit and hospice unit.
Methods: We performed a retrospective analysis of 174 patients who died in the cancer unit (CU) and 68 patients who died in the hospice unit (HU) from January 1, 2016 to December 31, 2016 at a hospital specializing in cancer treatment.
Results: The rate of life-sustaining treatment administration was lower for patients who died in the HU than that of those who died in the CU. The period until death after signing a DNR order was 7 days for CU patients and 19.5 days for the HU patients. The period from admission to death was also significantly longer in HU patients (32.5 days) than that in CU patients (21.5 days, p<.001). Of the patients who died in the CU, 54% were referred to the HU but did not use the service. Most of the people who signed DNR informed consents were spouses and offspring; only 4.6% of patients signed DNRs.
Conclusion: It is hard to say that life-sustaining treatment increases the survival period, but it can improve symptom control and quality of life in hospices. Activation of consultation-based hospice is necessary for patients who cannot use the hospice unit. To increase patient's active participation in the life-sustaining treatment decision of terminal cancer patients, it is necessary that an advanced practice nurse specialized in counseling and education is involved in the decision.
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KeyWords
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말기암, 암 환자, 심폐소생술금지, 연명치료, 호스피스
Terminal Cancer, Neoplasms, Do-Not-Resuscitate order, Life-sustaining treatment, Hospice Care
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원문 및 링크아웃 정보
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등재저널 정보
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