腦中風末期病人臨終前一個月於成人加護病房接受積極治療處置之情形

Stroke Terminal Decedents Receiving Aggressive Medical Treatment in the Adult Intensive Care Unit in the Last Month of Life

10.6831/TMU.2015.2015.00089

許佳晴

積極治療處置 ； 腦中風末期 ； 成人加護病房 ； terminal stroke ； adult intensive care unit ； aggressive medical treatment.

臺北醫學大學護理學系碩士暨碩士在職專班學位論文

2015年

碩士

林佳靜

繁體中文

腦中風對病人及家屬而言是個極具毀滅性的疾病，其末期症狀與癌症病人末期症狀相似。國外有研究指出20∼30%的腦中風病人在發病30天內便會死，其中9.6%的腦中風病人在死亡前一刻仍接受積極治療。本研究想藉由全民健康保險研究資料庫，探討國內腦中風末期病人臨終前一個月於成人加護病房所接受的積極醫療處置 。 本研究為回溯性研究，使用次級資料分析從「全民健康保險學術研究資料庫」選取腦中風末期病人為研究對象。資料分析採用描述性統計、 t檢定（t-test）、邏輯式迴歸分析（logistic regression）和複迴歸分析（multiple regression）。 研究結果顯示腦中風末期病人在死亡一個月於醫學中心和區域醫院仍接受多種積極治療，年紀越輕病人也傾向接受積極治療，皆達顯著差異（ p<.05）。本研究結果希望能減少無效的治療，並幫助更多的人能夠善終。

Stroke is a devastating illness for patients and their families. The symptoms of stroke is similar to terminal cancer. Some studies indicate 20 to 30% of stroke patients will die within 30 days of the onset, and 9.6 % of stroke patients is still receiving aggressive treatment before the moment of death. The purpose of the study was to investigate the aggressive medical treatment of stroke terminal patients in the adult intensive care unit in the last month of life.A retrospective study design using the " National Health Insurance Research Database " was undertaken. Descriptive analysis, t-test , logistic regression and multiple regression were used for data analysis. The results from the study show that the terminal stroke patients still receive a variety of aggressive treatment in academic medical centers and metropolitan hospitals.The younger patients also tend to receive aggressive treatment significantly (p <.05). The results of the study hopes to reduce futile medical care, and help more people to be palliative.

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