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Difference in the Duration and Frequency of Visits in Stages of End-of-Life Home Care Nursing: A Comparison between Cancer and Non-Cancer Cases

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  • 終末期の訪問看護における時期別の期間と訪問頻度の違い―がんとがん以外の事例の比較―
  • シュウマツキ ノ ホウモン カンゴ ニ オケル ジキ ベツ ノ キカン ト ホウモン ヒンド ノ チガイ ガン ト ガン イガイ ノ ジレイ ノ ヒカク
  • ─がんとがん以外の事例の比較─

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Abstract

Objective: We examined the duration of specific stages in the end-of-life period of older adults living at home, and the changes in the frequency and other structures of nurses' home visits during these stages. We compared cancer and non-cancer cases.<br>Method: Thirty-one nurses from home care nursing stations where “good” nursing care is provided, were interviewed concerning the practice of end-of-life care for patients that were 65 years and over, in both cancer and non-cancer cases. The end-of-life period was classified into onset, maintenance, worsening, and dying stages, and the differences in duration, visit frequency and other structural characteristics in each stage were statistically compared between cancer and non-cancer cases.<br>Results: The length of the onset and worsening stages among non-cancer cases was significantly longer and more varied than that among cancer cases. The visit frequency for cancer cases became significantly higher in the dying stage, while it became higher from the worsening stage among non-cancer cases. On-call home visits were provided for almost half of the non-cancer cases in the dying stage.<br>Conclusion: The findings suggest that the necessary end-of-life care, and the frequency of nurses' home visits were different between cancer and non-cancer cases. In order to provide appropriate care for each patient, improvement in the reimbursement system for home care nursing, as well as the skills of individual nurses, may need to be considered.

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