| Summary: | 碩士 === 長庚大學 === 護理學系 === 101 === This study aimed to understand the quality of pain management for patients with cancer before death and to compare the quality of pain management between patients receiving hospice and non-hospice care. This study used retrospective chart review design. A stratified random sampling was used to draw a sample of 511 cancer patients (non-hospice = 307, hospice = 204) who died in 2011 from three hospitals of the same medical system located in northern Taiwan. The data collection tools included demographic questionnaire, analgesics use form, and quality indicators for cancer pain management.
The results showed that the overall achievement rate for process quality indicators was 17.6%. Among the 11 process indicators, two had more than 50% of patients reached the standard: "re-assessment for moderate to severe pain" and "bowel regiment initiated for patients with opioids”. Four indicators had less than 10% of patients met the standards: "comprehensive assessment-other", "analgesic side effects monitored", "non-pharmacological therapies used" and "pain education to patients or families".
Regarding the outcome indicators (i.e., pain relief), compared to the initial pain intensity, the averaged 72-hour pain intensity reduced by 1.02 points (SD = 3.56). However, the averaged pain intensity within 3 days before death increased by 0.13 points (SD = 2.97). The multivariate analysis showed that patients receiving hospice and non-hospice care only differed on two process quality indicators: "use of valid pain scale at admission or initial pain" and "bowel regiment initiated for patients with opioids".
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