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Unmet palliative care needs among patients with end-stage kidney disease: a national registry study about the last week of life.

Artikel i vetenskaplig tidskrift
Författare Lena Axelsson
Anette Alvariza
Jenny Lindberg
Joakim Öhlén
Cecilia Håkanson
Helene Reimertz
Carl-Johan Fürst
Kristofer Årestedt
Publicerad i Journal of Pain and Symptom Management
Volym 55
Nummer/häfte 2
Sidor 236-244
ISSN 1873-6513
Publiceringsår 2018
Publicerad vid Centrum för personcentrerad vård vid Göteborgs universitet (GPCC)
Institutionen för vårdvetenskap och hälsa
Sidor 236-244
Språk en
Länkar dx.doi.org/10.1016/j.jpainsymman.20...
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämneskategorier Omvårdnad, Palliativ medicin

Sammanfattning

End-stage kidney disease (ESKD) is characterized by high physical and psychological burden and therefore, more knowledge about the palliative care provided close to death is needed.To describe symptom prevalence, relief and management during the last week of life, as well as end-of-life communication, in patients with ESKD.This study was based on data from the Swedish Register of Palliative Care. Patients aged 18 or older who died from a chronic kidney disease, with or without dialysis treatment (ICD-10-SE; N18.5 or N18.9), during 2011 and 2012 were selected.472 patients were included. Of six predefined symptoms, pain was the most prevalent (69%), followed by respiratory secretion (46%), anxiety (41%), confusion (30%), shortness of breath (22%), and nausea (17%). Of patients with pain and/or anxiety, 32% and 44% respectively were only partly relieved or not relieved at all. Of patients with the other symptoms, a majority (55%-84%) were partly relieved or not relieved at all. End-of-life discussions were reported in 41% of patients and 71% of families. A minority died in specialized palliative care: 8% in hospice/in-patient palliative care and 5% in palliative home care. Of all patients, 19% died alone. Bereavement support was offered to 38% of families.Even if death is expected, the majority of patients dying with ESKD had unmet palliative care needs regarding symptom management, advance care planning, and bereavement support.

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