The Choice Of Palliative Support And Hospice Tendency Surveys

Objective:The objective is to understand the choice tendency of palliative support and Hospice by the advanced malignant tumor patients, primary caregivers and medical personnel, and the similarities and differences of their choices.Method:By using the questionnaire survey, this research recorded 140 pieces of advanced malignant tumor patients from the carcinoma department in Guang'anmen hospital affiliated with Chinese Academy of Traditional Chinese Medicine and Bei jng Puxiang TCM Cancer Hospital, 141 pieces of primary caregivers and 108 pieces of medical personnel. These questionnaires include personal basic information, diagnosis, previous treatment and efficacy evaluation, the quality of life and emotional assessment. Interviewees should order the side effects, therapeutic, the delay time of survival and economic pressure, according to the important degree sequence of a patient's medical case given by the questionnaires. Then the interviewees should choose the acceptable combinations which combined by the 4 factors, and give the delay time of survival. And then the interviewee should give the choices whether the patient accept palliative support and Hospice or not. Finally, the interviewee reshow the tendency of the same question(0-7degree,0 means very should choose palliative support and Hospice,7 means should not choose completely). In order to avoid the words' negative induction effect, the questionnaires use "Comfortable plan" instead of "palliative" and " dying"Result:1 Comparing with the importance of side effects, therapeutic, the delay time of survival and economic pressure delay the survival time The most importance is the delay time of survival. Clinic patients'families pay more attentions to therapeutic and economic pressure relative to inpatients'families pay more attentions to the side effects. Doctors put the side effects on the second, the third is economic pressure, the last one is therapeutic. Most of the other groups pay least attention to economic pressure.2 Comparing the 16 combinations which combined by the 4 factors Inpatients choose more combinations of treatments than clinical patients, but they have low expect of delaying the survival time. This is no significant differences between both of two group of families. Patients and their families in the idea is unified. The differents of doctors and nurses'opinions are not too big. The doctor's except of the delay time of survival in several individual solutions is shorter than nurses'. Patients and families have is a disparate compares with doctors.3 Comparing the rate of chosen of palliative support and hospice Inpatients'families'rate is the lowest,37.9%; clinical patients'families'is the highest,59.3%; Less than half; 9 results of pairwise comparisons show the no too obvious differences between groups. There is only statistically significant differences only between the clinical patients and inpatients'families'(P=0.000).4 Comparing the choose tendency (0-7 degree)When the choice in rough, there is not significant differences between the groups, but give more affecting the details in life, the difference is obvious. It show the complexity of the choices.Conclusion:1 Comparing the materialitylevel of the side-effect,therapeutic, the delay time of survival and economic pressureALL the six groups put the delay time of survival in the first place. The families of clinical patients rather than inpatients'families pay more attentions to therapeutic and economic pressure. Doctors put the side effect and economic pressure in the second and third place. The other five groups consider with least of economic pressure.2 Comparing the 16 combinations which combined by the 4 factorsInpatients choose more combinations of treatments than clinical patients, but they have low expect of delaying the survival time. This is no significant differences between both of two group of families. Patients and their families in the idea is unified. The differents of doctors and nurses'opinions are not too big. The doctor's except of the delay time of survival in several individual solutions is shorter than nurses'. Patients and families have is a disparate compares with doctors. One side, doctors have higher enthusiasm to every treatments, on the other side they have lower expect of the delay time of survival.3 Comparing the rate of chosen of palliative support and hospice Every group has not higher acceptance of palliative support and hospice4 Choose attitude (0-7 degree)Inpatients and their families have the unities. The reason is that they may have good communications. Other pairwise comparisons according to choose mean significant differences from little arrive much is clinic patient-the doctor, clinic patient caregivers doctor, inpatient clinic patient, doctor nurse, inpatient-doctor, inpatient caregivers nurses, clinic patient-clinic patient caregivers, inpatient caregivers-clinic patient caregivers.From the perspective of various factors, the tendency is different from the instinct choice after giving the various factors. The attitudes of different crowd to the same issue are distinct. The distinct is bigger When the patients are apart from or distrust the important one (like mates, children, parents and doctors).