Continuous Electrocardiographic Monitoring for 24 Hours Before Death in Patients with Terminal Cancer.

Ko Sato, Mika Baba, Tatsuya Morita, Kento Masukawa, Yasuo Shima, Satoru Tsuneto, Yoshiyuki Kizawa, Mitsunori Miyashita
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Abstract

Background: Purposeless physiological monitoring at the end-of-life is not recommended. However, studies on how families feel regarding the death of patients with terminal cancer without continuous electrocardiographic monitoring (CEM) are lacking.

Objectives: To explore the impact on the quality of care and the feelings and psychological distress experienced by families when CEM is not used during the 24 hours preceding a patient's death.

Methods: In this multicenter cross-sectional, self-report questionnaires were distributed to 1087 bereaved families at Japanese specialized palliative care units in 2018.

Results: Out of 671 responses, 394 valid responses were analyzed. Families of nonmonitored patients (NM-group) accounted for 79.2%, while those with bedside electrocardiogram monitoring (MB-group) and remote nurse station monitoring (MC-group) comprised 11.9% and 8.9%, respectively. In the NM-group, 85.5% expressed satisfaction without CEM, which was more than 10% lower than other groups. While 14% in the NM-group desired patient monitoring, families who received adequate explanations about CEM had lower proportions compared to the MB-group (P = .021). Univariate analyses showed no significant differences in evaluations of the quality of care and families' psychological distress (mean scores of Overall Care Satisfaction, Care Evaluation Scale, Good Death Inventory, Brief Grief Questionnaires) across all groups.

Conclusion: While the majority of NM-group were satisfied with their patient's care without CEM, the proportion of dissatisfied families was higher than in other groups. Although not using CEM is not a major hindrance to end-of-life care for patients with terminal cancer, providing sufficient explanations may be important for satisfactory care.

癌症晚期患者死亡前 24 小时连续心电图监测。
背景:不建议在临终时进行无目的的生理监测。然而,关于癌症晚期患者在没有持续心电监护(CEM)的情况下死亡,家属的感受如何的研究尚属空白:目的:探讨在患者死亡前 24 小时内不使用 CEM 对护理质量的影响以及家属的感受和心理压力:在这项多中心横断面研究中,于2018年向日本专业姑息治疗病房的1087个遗属发放了自我报告问卷:在 671 份答卷中,对 394 份有效答卷进行了分析。未接受监测的患者家属(NM组)占79.2%,接受床旁心电图监测(MB组)和远程护士站监测(MC组)的患者家属分别占11.9%和8.9%。在 NM 组中,85.5% 的人对没有 CEM 表示满意,比其他组低 10%以上。虽然 NM 组中有 14% 的人希望对患者进行监护,但与 MB 组相比,得到有关 CEM 的充分解释的家庭比例较低(P = .021)。单变量分析显示,所有组别在护理质量评价和家属心理压力(护理总体满意度、护理评价量表、美好死亡量表、简短悲伤问卷的平均得分)方面均无显著差异:虽然大多数 NM 组对未使用 CEM 的病人护理感到满意,但不满意的家属比例高于其他组别。虽然不使用 CEM 并不是晚期癌症患者临终关怀的主要障碍,但提供充分的解释可能对满意的护理非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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