巴金森氏症病人症狀及緩和治療相關因素之研究

Purposes: Parkinson's disease (PD) is a progressive degenerative disease of the central nervous system. It significantly affects patients' quality of life due to the long disease course, long-term dysfunction, and various symptoms. In addition, the palliative care utilization rate is only 0.6%. The purpose of this study was to explore the factors related to the symptoms and palliative treatment of patients with PD, so as to provide better care for patients. Methods: This study employed a cross-sectional correlational study design, and purposive sampling was used to enroll 64 participants. The inclusion criteria for patients were: (1) diagnosis with primary PD disease; (2) clear mental state, free from psychiatric diseases and dementia; and (3) provision of informed consent after the aim of the study was explained to him/her. A set of validated instruments, including the Palliative Outcome Scale-Parkinson Disease (POS-PD) and Palliative Outcome Scale (POS), were used for data collection. SPSS 19.0 software was used for data analysis. The statistical methods included an independent sample t-test, one-way analysis of variance, and regression analysis. Results: Subjects with caregivers, higher Hoehn and Yahr stage or those who visited the emergency department had a significantly higher need for palliative care, which also represents a poor quality of life. PD symptoms showed moderate positive correlation with palliative care outcomes (r=0.65, p＜0.001), showing that the quality of life was poorer when symptoms were more severe and required more palliative intervention. Stepwise regression analysis results showed that symptom severity was a predictor of palliative treatment in PD patients and could explain 41.9% of palliative care outcome variance. Conclusions: When the severity of symptoms of PD patients increases and there is an increased need for palliative care, healthcare providers should communicate palliative care concepts early to provide patient care options to improve outcomes.