Palyatif Bakım Hastalarında Klinik Özellikler ve Prognostik Faktörler

Yürüyen, Mehmet; Tevetoglu, Isil Ozbas; Tekmen, Yeliz; Polat, Özlem; Arslan, İsmail; Okuturlar, Yıldız

doi:10.18521/ktd.368570

Cited by 21 publications

(23 citation statements)

References 13 publications

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“…Similar to a previous study from Turkey, more than 80% of the patients we evaluated were immobile on admission [21]. The likelihood of prolonged LOS in individuals with mobilization limitation was 2.3 times higher in the medium stay or long stay tertiles than the short LOS tertile.…”

Section: Discussionsupporting

confidence: 80%

“…In the present study, we identified potential indicators of prolonged LOS that can be assessed on admission to the PCU. Our participants represented a typical PCU because of the similarities in average age, gender distribution, proportions of patients with major comorbidities, and median LOS with some previous national [21,22,23] and international [24,10] reports.…”

Section: Discussionmentioning

confidence: 99%

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Factors influencing the length of stay in the palliative care unit in patients discharged home: results from a tertiary hospital in Turkey

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Taşçı

2021

Turk J Med Sci

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Background/aimIncreased length of stay (LOS) in the palliative care unit (PCU) is a serious burden to the patients and the health care system. The predictors of longer LOS in a PCU have not been reported so far from Turkey. Our aim in this study was to evaluate the factors associated with the LOS in the PCU of a tertiary hospital. Materials and methodsThis cross-sectional analysis of a retrospective cohort evaluated adult patients' medical records admitted to the PCU between 2017 and 2019. The main inclusion criteria were four or more days of palliative unit stay and being home discharge during the study period. Data on demographics, chronic diseases, mobilization disability, route of feeding, tracheostomy, sleep disturbances, pressure ulcers, and antidepressant use were collected. Potential factors associated with prolonged LOS tertiles were examined by ordinal regression analysis. ResultsA total of 287 discharges from the PCU to home were analyzed. Mean (SD) age was 70.5 (15.8) years, and there was a male predominance (55.7%). The majority of patients had malnutrition, mobility limitation, hypertension, malignant disease, and sleep disturbances. Median LOS was 15 days (4-79).Mean age, hypertension, infections, mobilization limitation, tube feeding, permanent tracheostomy, and pressure ulcers increased from the short stay tertile (4-12 days) to the medium stay tertile (13 to 20 days) and long stay tertile (>21 days) of LOS. Mobilization limitation (p=0.013, OR: 2.34 (95%CI:1.19-4.60)), tube feeding (p=0.001, OR: 2.63 (95%CI: 1.49-4.66), permanent tracheostomy (p=0.007, OR: 4.10 (95%CI: 1.48-11.36)), and hypertension diagnosis (p=0.023, OR:1.80, 95%CI: 1.09-2.98) on admission were associated with being in the medium stay or long stay tertiles of LOS compared to the lowest tertile. ConclusionA longer length of PCU stay is associated with mobilization limitation, tube feeding, permanent tracheostomy, and hypertension. We found no evidence that age, infections or pressure ulcers on admission were associated with extra LOS in the PCU in patients discharged home.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Factors influencing the length of stay in the palliative care unit in patients discharged home: results from a tertiary hospital in Turkey

Zengin

Taşçı

2021

Turk J Med Sci

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“…Palliative care centers have started to be established in inpatient health facilities within the scope of the "Directive About the Application Procedures and Principles of Palliative Care" which came into force in 2015. In these centers, patients with multiple chronic problems and end-stage cancer patients are followed and receive treatment [5].…”

Section: Introductionmentioning

confidence: 99%

Palyatif bakim merkezlerinde tedavi gören hastaların değerlendirilmesi

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Benli

Gökçek

et al. 2020

Family Practice and Palliative Care

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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.

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“…21 PB'de bası yarası, beslenme sorunları ve ek hastalıkların varlığı, hastaların yatış süresini uzatarak taburculuk oranını azaltmaktadır. 23 Mortalite oranının yüksek oranda görüldüğü, uzun süreli yatışların olduğu ve tedaviye cevabın çok iyi alınamadığı son dönem bakım hastalarının takip edildiği PB ünitelerinde çalışan sağlık personeli tükenmişlik gibi ruhsal sorunlar yaşayabilmektedir. 24 Çalışmamızda ise çalışanların %87,5'i PB'de sürekli kayıpla karşılaştıkları için tükenmişlik yaşamalarının kaçınılmaz olduğunu belirtmişlerdir.…”

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“…Türkiye'de çoğu kurumda aktif bir PB poliklinik hizmeti verilmemektedir. 23,27 Mevcut çalışmada ise çalışanların yarısı "PB poliklinik hizmeti verilmelidir." fikrine katılmıştır.…”

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Determination of Knowledge and Opinions on Palliative Care of Workers in Intensive Care and Palliative Care Units: A Survey Study

Miniksar¹,

Dişli²,

Tunç³

et al. 2020

J Tradit Complem Med

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ÖZET Amaç: Yoğun bakım (YB) ve palyatif bakım (PB) üniteleri yaşam sonu bakımın uygulandığı kliniklerdir. PB hizmetlerinin optimal düzeyde verilebilmesi için bu ünitelerde çalışanların PB hakkında yeterli düzeyde bilgi sahibi olması gerekmektedir. Bu çalışmanın amacı, YB ve PB ünitelerinde çalışan doktor ve hemşirelerin PB'ye ilişkin bilgi ve görüşlerinin belirlenmesi ve karşılaştırılmasıdır. Gereç ve Yöntemler: Çalışma; Malatya Eğitim ve Araştırma Hastanesi Reanimasyon YB, Dahiliye YB ve PB ünitelerinde çalışan hekim ve hemşireler ile yüz yüze görüşme yöntemi ile yapılmıştır. Çalışmada veriler, sosyodemografik özellikler formu ve literatür bilgileri doğrultusunda hazırlanan, çalışanların PB'ye yönelik mevcut bilgi ve görüşlerini belirleyici anket formu kullanılarak elde edilmiştir. Bulgular: Çalışmaya katılanların (68 hemşire, 12 doktor) yaş ortalaması 34 olup, çoğunluğunu lisans mezunu kadınlar oluşturmaktaydı. Katılımcıların %80'i eğitimleri sırasında PB eğitimi almadıklarını ve %76,3'ü yapılacak eğitim programlarına ihtiyaç duyduklarını belirtti. YB çalışanlarının %37,5'i, PB çalışanlarının %20'si hospis tanımını bilmediklerini ifade etti. PB çalışanlarının çoğu (%85,1) tedavisi biten hastaların taburculuğunda zorlandıklarını ve %85,5'i PB'de tükenmişlik yaşadıklarını belirtti. YB hemşirelerinin %63,8'i "YB"de PB hizmeti verilmelidir, ifadesine katılmadıklarını ve bu konu hakkında bilgi sahibi olmadıklarını belirtti. Çalışanların tamamına yakını, PB temel eğitiminin üniversite eğitim programlarında zorunlu olması gerektiğini belirtti. Sonuç: YB ve PB ünitesinde çalışan sağlık personelinin "Palyatif bakım ve hospis" kavramları konusunda yeterli bilgiye sahip olmadıkları, bilgi düzeylerinde farklılıklar olduğu ve bu konuda yapılacak eğitim programlarına ihtiyaç duydukları belirlenmiştir. Bu durumun temel lisans eğitimindeki eksikliklerden kaynaklandığı, eğitim müfredatında zorunlu PB eğitim dersinin yer alması ve sertifikalı eğitim programlarının yaygınlaşması gerektiği düşünülmektedir.Anah tar Ke li me ler: Palyatif bakım; yoğun bakım; sağlık personeli; bilgi ABS TRACT Objective: Intensive care (ICU) and palliative care (PD) units are clinics where end-of-life care is applied. In order for PB services to be provided at an optimal level, employees working in these units should have sufficient knowledge about PB. The aim of this study is to determine and compare the knowledge and opinions of doctors and nurses working in the ICU and PD units about palliative care. Material and Methods: Study; Malatya Training and Research Hospital Reanimation YB, Internal Medicine YB and PB were conducted by face to face interviews with physicians and nurses working in the units. In the study, the data were obtained by using the questionnaire form, which was prepared in line with the socio-demographic characteristics form and the literature information, and which determines the current knowledge and opinions of the employees about PD. Results: The average age of the participants (68 nurses, 12 doctors) was 34, most of whom were ...

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Palyatif Bakım Hastalarında Klinik Özellikler ve Prognostik Faktörler

Cited by 21 publications

References 13 publications

Factors influencing the length of stay in the palliative care unit in patients discharged home: results from a tertiary hospital in Turkey

Factors influencing the length of stay in the palliative care unit in patients discharged home: results from a tertiary hospital in Turkey

Palyatif bakim merkezlerinde tedavi gören hastaların değerlendirilmesi

Determination of Knowledge and Opinions on Palliative Care of Workers in Intensive Care and Palliative Care Units: A Survey Study

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