predictors of dying at home for patients receiving nursing services in japan a retrospective study comparing cancer and non-cancer deaths在家预测死亡的患者接受护理服务在日本一个回顾性研究比较癌症和非癌症死亡.pdfVIP

Ikezaki and Ikegami BMC Palliative Care 2011, 10:3 /1472-684X/10/3 RESEARCH ARTICLE Open Access Predictors of dying at home for patients receiving nursing services in Japan: A retrospective study comparing cancer and non-cancer deaths * Sumie Ikezaki , Naoki Ikegami Abstract Background: The combined effects of the patient’s and the family’s preferences for death at home have in determining the actual site of death has not been fully investigated. We explored this issue on patients who had been receiving end-of-life care from Visiting Nurse Stations (VNS). In Japan, it has been the government’s policy to promote end-of-life care at home by expanding the use of VNS services. Methods: A retrospective national survey of a random sample of 2,000 out of the 5,224 VNS was made in January 2005. Questionnaires were mailed to VNS asking the respondents to fill in the questionnaire for each patient who had died either at home or at the hospital from July to December of 2004. Logistic regression analysis was respectively carried out to examine the factors related to dying at home for cancer and non-cancer patients. Results: We obtained valid responses from 1,016 VNS (50.8%). The total number of patients who had died in the selected period was 4,175 (cancer: 1,664; non-cancer: 2,511). Compared to cancer patients, non-cancer patients were older and had more impairment in activities of daily living (ADL) and cognitive performance, and a longer duration of care. The factor having the greatest impact for dying at home was that of both the patient and the family expressing such preferences [cancer: OR (95% CI) = 57.00 (38.79-83.76); non-cancer: OR (95% CI) = 12.33 (9.51-15.99)]. The Odds ratio was greater compared with cases in which only the family had expressed such a preference and in which only the patient h