Dying at home in Belgium: a descriptive GP interview study

BMC Family Practice

Research Article

Joachim Cohen¹  Kathleen Leemans¹  Lieve Van den Block²  Johan Bilsen³  Luc Deliens⁴  Nicole Boffin⁵ 

[1] Ghent University & Vrije Universiteit Brussel End-of-Life Care Research Group, Brussels, Belgium;Ghent University & Vrije Universiteit Brussel End-of-Life Care Research Group, Brussels, Belgium;Department of Family Medicine, Vrije Universiteit Brussel, Brussels, Belgium;Ghent University & Vrije Universiteit Brussel End-of-Life Care Research Group, Brussels, Belgium;Department of public health, Vrije Universiteit Brussel, Brussels, Belgium;Ghent University & Vrije Universiteit Brussel End-of-Life Care Research Group, Brussels, Belgium;EMGO Institute for Health and Care Research, VU University Medical Centre, Department of Public and Occupational Health, Amsterdam, The Netherlands;Scientific Institute of Public Health, OD Public Health and Surveillance, Brussels, Belgium;

关键词: General Practitioner;    Palliative Care;    Psychological Symptom;    Symptom Burden;    Interview Study;   

DOI  :  10.1186/1471-2296-13-4

 received in 2011-06-30, accepted in 2012-01-19,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundWhile increasing attention is being paid to enabling terminal patients to remain at home until death, limited information is available on the circumstances in which people at home actually die. Therefore this study aims to describe patient characteristics, functional and cognitive status and physical and psychological symptom burden in the last three months of life among Belgian patients dying at home, according to their GPs.MethodsIn 2005, a nationwide and retrospective interview study with GPs took place on people dying at home in Belgium as reported by Sentinel Network of GPs in Belgium. GPs registered all deaths (patients aged 1 year or more) weekly and were interviewed about all patients dying non-suddenly at home, using face-to-face structured interviews.ResultsInterviews were obtained on 205 patients (90% response rate). Between the second and third month before death, 55% were fully invalid or limited in self-care. In the last week of life, almost all were fully invalid. Fifty four percent were unconscious at some point during the last week; 46% were fully conscious. Most frequently reported symptoms were lack of energy, lack of appetite and feeling drowsy. Conditions most difficult for GPs to manage were shortness of breath, lack of energy and pain.ConclusionsMany people dying at home under the care of their GPs in Belgium function relatively well until the last week of life and cognitive status seems to be preserved until the end in many cases. However, symptoms which GPs find difficult to control still manifest in many patients in the final week of life.

【 授权许可】

CC BY   
© Leemans et al; licensee BioMed Central Ltd. 2012