晚期肿瘤患者姑息护理手册的编制和应用

目的编制适合晚期肿瘤患者阅读的姑息护理手册,并在老年病房开展姑息护理教育。方法通过文献检索、参考相关书籍和资料,结合前期研究结果形成姑息护理手册提纲,由3名护理专家和1名心理专家进行评议修订,进行小样本预试验后,征求患者和家属的意见再进行补充和调整,形成正式手册,并应用于30例晚期肿瘤患者中。采用简明健康状况调查表(short form 36questionnaire,SF-36)测评应用手册前后患者的生活质量。结果患者通过学习姑息护理手册,对疾病认知、症状控制、心理调适、社会支持、死亡教育、家属哀伤辅导等方面的知识有所了解,学习前后躯体角色、机体疼痛、社会功能、心理健康评分以及SF-36总分的差异均有统计学意义(均P0.05)。结论姑息护理手册的编制和应用是老年科病房开展姑息护理教育的有益探索和初步实践,该手册可以作为老年晚期癌症患者的死亡教育指引,也有助于护理人员提高姑息护理知识和技能,帮助患者减轻身心两方面的痛苦。

Editing and Application of the Handbook of Palliative Care for Patients with Terminal Tumor

Objective To write and edit the handbook of palliative care for elderly patients with terminal tumor and to explore its preliminary application.Methods Based on literature search,review of relevant books and materials,and combined with research result from the early stage investigation to draw up the draft of the handbook of palliative care.The draft was revised by three nursing experts and a psychological expert.Pilot test was performed in a small sample.The contents of the handbook were supplied and revised based on the comments from the patients and their families,and a final version was formed.The handbook was used in 30 patients with terminal tumor,and quality of life before and after was tested by SF-36 scale. Results Patients had certain knowledge about the cognition of tumor,symptoms controlling,psychological adjustment,social support,death education and family grief counseling through the palliative care handbook study.There were significant differences in physical role,bodily pain,social function,mental health and to-tal score of SF-36 showed before and after learning(P <0.05).Conclusion Editing and applying the hand-book of palliative care for elderly patients with terminal tumor has carried on the exploration and prelimi-nary practice.It can be used as death education guideline for the patients,and is useful for nurses to improve their knowledge and skills about palliative care to help relieve patients’pain on their body and mind.