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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/32275

    標題: Association between palliative care and life-sustaining treatments for patients with dementia: A nationwide 5-year cohort study
    作者: Chen, Ping-Jen
    Liang, Fu-Wen
    Ho, Chung-Han
    Cheng, Shao-Yi
    Chen, Yi-Chen
    Chen, Yu-Han
    Chen, Yueh-Chun
    貢獻者: Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Family Med
    Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Div Geriatr & Gerontol
    Chi Mei Med Ctr, Palliat Care Ctr
    Natl Cheng Kung Univ, Coll Med, NCKU Res Ctr Hlth Data
    Natl Cheng Kung Univ, Coll Med, Dept Publ Hlth
    Chi Mei Med Ctr, Dept Med Res
    Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm
    Natl Taiwan Univ, Dept Family Med, Coll Med
    Natl Taiwan Univ, Univ Hosp
    Chi Mei Med Ctr, Dept Family Med
    Chi Mei Med Ctr, Dept Nursing
    關鍵字: Cross-cultural comparison
    life-support care
    national health programmes
    palliative care
    日期: 2018-03
    上傳時間: 2019-11-15 15:47:46 (UTC+8)
    摘要: Background: The association between palliative care and life-sustaining treatments for patients with dementia is unclear in Asian countries. Aim: To analyse the use of palliative care and its association with aggressive treatments based on Taiwanese national data. Design: A matched cohort study was conducted. The association between intervention and outcome was evaluated using conditional logistic regression analyses. Setting/participants: The source population comprised 239,633 patients with dementia diagnosed between 2002 and 2013. We selected patients who received palliative care between 2009 and 2013 (the treatment cohort; N=1996) and assembled a comparative cohort (N=3992) through 1:2 matching for confounding factors. Results: After 2009, palliative care was provided to 3928 (1.64%) patients of the dementia population. The odds ratio for undergoing life-sustaining treatments in the treatment cohort versus the comparative cohort was <1 for most treatments (e.g. 0.41 for mechanical ventilation (95% confidence interval: 0.35-0.48)). The odds ratio was >1 for some treatments (e.g. 1.73 for tube feeding (95% confidence interval: 1.54-1.95)). Palliative care was more consistently associated with fewer life-sustaining treatments for those with cancer. Conclusions: Palliative care is related to reduced life-sustaining treatments for patients with dementia. However, except in the case of tube feeding, which tended to be provided alongside palliative care regardless of cancer status, having cancer possibly had itself a protective effect against the use of life-sustaining treatments. Modifying the eligibility criteria for palliative care in dementia, improving awareness on the terminal nature of dementia and facilitating advance planning for dementia patients may be priorities for health policies.
    link: http://dx.doi.org/10.1177/0269216317751334
    關聯: Journal of Cosmetic Science, v.32, n.3, SI, pp.622-630
    Appears in Collections:[藥學系(所)] 期刊論文

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