Brytpunktssamtal - En registerstudie i palliativ vård
Sammanfattning: Abstract Background: When curative treatment no longer has any effect the care is transferred into palliative care, the transition is called breakpoint. Previous studies have shown that information about the transition to palliative care leads to empowerment, participation and a more adequate care. The goal is that all patients and their families should be offered breakpoint dialogue since the patients are entitled to information. Despite that the breakpoint dialogue was carried out with only half of all the patients and about 70% of their relatives in the Västra Götaland region. There is no overall picture of implementation of breakpoint dialogues in medicine clinics compared with oncology clinics. The basis of palliative care according to the National Board of Health and Welfare is: symptom relief, teamwork, communication and relationship, as well as support for relatives.Objective: The aim of the study was to examine the proportion of patients over 18 years and their families as it is implemented breakpoint dialogue with in medicine- and oncology units, and whether there are differences between the two clinics. Question - How do breakpoint dialogue and decision of breakpoint co-vary with more efforts in the palliative care?Methods: The study is a descriptive and analytic retrospective registry study based on data from The Swedish Register of Palliative Care. In total of 2479 patients >18 years were included in the study at hospitals in Västra Götalandsregionen.Findings: There are carried out a higher percentage of breakpoint dialogues carried out with patients and families in oncology. More next of kin than patients takes part in breakpoint dialogue than it is documented. Fewer patients are taking part of breakpoint dialogue than the actual decisions. Although the majority of the patients still have the ability to express his and her wish the last week of life, breakpoint dialogue is carried out for barely half of the patients in medicine and about 76% in oncology. There are more breakpoint dialogues are carried out with patients younger than 65 years. If the decision of transition to palliative care is documented and breakpoint dialogue are implemented with the patient and/or the next of kins covaries with more efforts.Conclusion: Although more than twice as many takes part in breakpoint dialogue in oncology than medicine there are performed too few breakpoint dialogues in both of the clinics. There are a higher percentage women and younger patients in oncology than medicin. If more decisions of transition to palliative care are documented and more breakpoint dialogues are implemented, patients can get more adequate palliative care.Keywords: Palliative care, Breakpoint dialogue, The Swedish Register of Palliative Care (SRPC), Four cornerstones, Palliative values.
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