姑息护理在妇科晚期癌症病人中的应用

由于社会的进步和科技的发展，癌症成为人类的主要杀手之一，姑息护理作为一种新的服务项目，填补了现代医疗服务体系中的空白。姑息护理其目的在于给临终病人减轻精神上和肉体上的痛苦，提高他们的生命质量，让临终病人在有限时间内，安详、舒适并有尊严而无憾地走过人生旅程的最后一站，同时也为病人家属提供一个较为理想的精神过渡期一心理缓解，创造一个优良的情感与外部环境，从而达到让死者安然、生者无憾的目的。随着我院收治的各类妇科晚期癌症病人的增多，姑息护理的实施尤为重要。现根据我院实际情况，对2004年-2007年收治的妇科晚期癌症病人其中10例实施系统的姑息护理，收到满意的效果，现总结如下。     

探讨同理心在晚期癌症病人姑息护理中的应用

[目的]探讨同理心在晚期癌症病人姑息护理中的应用。[方法]对77例晚期癌症病人姑息护理中应用同理心进行会谈、倾听、观察,总结分析应用的效果。[结果]同理心的应用使大部分晚期癌症病人愿意表达内心感受,病人负性情绪减轻。[结论]同理心在晚期癌症病人姑息护理中的应用减轻了病人的身心痛苦,体现了对晚期肿瘤病人行姑息护理的目的和宗旨,提高了病人的生存质量。     

探讨同理心在晚期癌症病人姑息护理中的应用

[目的]探讨同理心在晚期癌症病人姑息护理中的应用。[方法]对77例晚期癌症病人姑息护理中应用同理心进行会谈、倾听、观察,总结分析应用的效果。[结果]同理心的应用使大部分晚期癌症病人愿意表达内心感受,病人负性情绪减轻。[结论]同理心在晚期癌症病人姑息护理中的应用减轻了病人的身心痛苦,体现了对晚期肿瘤病人行姑息护理的目的和宗旨,提高了病人的生存质量。     

临终关怀护理在晚期癌症病人中的应用

[目的]总结晚期癌症病人的临终关怀护理。[方法]对28例晚期恶性肿瘤病人进行临终关怀,包括基础护理、心理护理、疼痛护理、关注病人家属感受等。[结果]28例癌症病人基本平静地离开了人世,同时病人家属也得到了有效安慰,取得了满意的效果。[结论]对晚期癌症病人进行临终关怀护理,可提高病人生存质量,得到病人家属的认可。     

姑息护理在晚期肺癌病人中的应用

肺癌是常见恶性肿瘤之一,几十年来其发病率及病死率居高不下,即使经过积极治疗,大多数病人仍逃脱不了死亡的结局,临终病人遭受着癌症给他们带来的巨大痛苦,病人家属不仅要看护病人,同时他们心里也承受失去亲人的哀痛,他们同样需要社会和心里支持。随着对临终护理的关注,姑息护理逐渐被重视。世界卫生组织(WHO)于2002年对姑息护理的最新定义[1]：对所患疾病不能根治、进行性恶化或生存期较短的病人给予积极的整体护理,控制疼痛或非痛症状,解决心理、社会和精神等重要问题。姑息护理强调的重点是临终病人的生活质量[2],即动用各种切实有效的措施,控制病人的症状,同时进行心理护理,尽可能地减轻他们的身心痛苦,使病人在生命的最后阶段能够生活得有尊严、有意义。     

姑息护理在晚期癌症患者中的应用

姑息护理是随着临终关怀活动而逐渐产生和发展起来的一种全新的护理方式.1990年WHO提出:姑息护理是对那些对系统的治愈性治疗无反应的患者,给予积极的症状治疗和生活护理,更为重要的是控制疼痛及其他症状,给予心理、社会及精神上的支持[1].     

晚期癌症病人居家姑息照护现状及展望

对晚期癌症病人居家姑息照护的现状、居家姑息照护测量工具、开展居家姑息照护的必要性以及我国居家姑息照护中存在的问题进行综述,以期为我国开展居家姑息照护提供借鉴意见,推动我国居家姑息照护的发展,提高晚期癌症病人居家姑息照护质量。     

姑息护理干预在晚期肿瘤患者中的应用

目的 探讨姑息护理干预在晚期肿瘤患者中的临床应用效果.方法 将2006年1月～2008年12月入住本科并确诊为晚期肿瘤患者共155例,随机分为观察组(78例)和对照组(77例).观察组除实施常规护理外,给予姑息护理干预;对照组仅实施常规护理.比较2组患者的精神面貌、心态及死亡恐惧感、临终前要求共4项指标.结果 观察组患者在精神面貌、心态及死亡恐惧感、临终要求方面均优于对照组(均p＜0.01).结论 姑息护理干预有助于减轻晚期肿瘤患者的心理压力,树立正确的生死观,以乐观的心态度过人生的最后一段时光.     

标准化家居护理路径在晚期癌症病人中的应用

[目的]探讨标准化家居护理路径在晚期癌症病人中的应用效果。[方法]随机将200例晚期癌症病人分为对照组与实验组各100例,对照组采取常规护理,实验组采取标准化家居护理路径,比较干预后两组病人的疼痛程度、健康状况、生活质量、病历书写时间、护理工作缺失点及家属配合度。[结果]实验组干预后疼痛程度比对照组明显降低、健康状况及生活质量比对照组明显提高、病历书写时间比对照组明显缩短(P<0.05);其护理工作缺失点大大减少、家属配合度明显提高,均优于对照组(P<0.05)。[结论]采取标准化家居护理路径可提高病人的健康状况及生活质量、降低疼痛程度、缩短病历书写时间、提高家属配合度。     

中医特色护理在晚期癌症病人疼痛中的应用

目的:探讨中医特色护理在晚期癌症病人疼痛管理中的应用效果。方法:选取2018年12月—2019年12月在我院住院的115例晚期癌症病人为研究对象,采用随机数字表法随机将其分为观察组与对照组。对照组57例,使用常规疼痛护理方法,观察组58例,在对照组的基础上加入中医特色护理。结果:干预前两组晚期癌症病人视觉模拟评分、匹兹堡睡眠质量指数以及生活质量评估量表得分比较差异无统计学意义(P>0.05),经中医特色护理干预后观察组晚期癌症病人视觉模拟评分、匹兹堡睡眠质量指数得分低于对照组,生存质量评估量表得分高于对照组,两组比较差异有统计学意义(P<0.05)。结论:中医特色护理能够有效改善晚期癌症病人疼痛以及睡眠情况,提高其生活质量。     

人性化护理措施在妇产科手术患者护理中的应用研究

目的探讨研究人性化护理措施在妇产科手术护理过程中的应用。方法选择本院妇产科120名患者,随机分为实验组和对照组,每组60例,实验组患者给予人性化护理干预,对照组患者给予常规护理干预。在护理干预后观察2组患者各项指标,并对2组干预前后用护理质量评分和汉密尔顿焦虑量表进行评价。结果实验组干预后的各项指标如抑郁、焦虑等状态优于对照组(P0.05),且干预后护理质量评分和汉密尔顿焦虑量表评分优于对照组患者(P0.05)。结论对妇产科手术患者进行人性化护理干预可以有效缓解患者的焦虑和抑郁状态,有利于调节患者的心情,促进手术治疗的成功,值得在临床上推广和借鉴。     

Management of infections in palliative care patients with advanced cancer

To characterize infections and their management in oncology patients at the end of life, we conducted a review of the literature. Eight studies assessing infection in 957 patients with various malignancies were identified. Forty-two percent of terminally ill patients developed infections in the final phase of care. The greatest frequency of treatment with antibiotics occurred in acute care hospitals. Enterobacteriaceae and S. aureus were the most frequently isolated bacteria, and urinary and respiratory tracts the most frequently involved sites of infection. A total of 19-39% of individuals with suspected infection and advanced cancer died. The decision whether to treat or not in the palliative care setting may be complex and requires an individualized approach. Further research in this area will help develop a consensus for management that will facilitate education of students and residents regarding complex decisions of care of infections at the end of life.     

腹腔镜在妇科的应用及其护理进展

随着科学技术的发展 ,新的医疗器械不断开发和应用 ,腹腔镜在妇科各种疾病的诊断和治疗中广泛使用 ,微创手术逐渐被人们认识和接受 ,但同时也向临床护理提出了新的要求。     

晚期癌症病人家庭临终护理的研究进展

综述近年来国内外晚期癌症病人家庭护理模式的研究进展,探讨我国开展晚期癌症病人家庭临终护理存在的问题和解决方法,指出未来应着重培养专业的家庭临终医护人员,健全家庭临终护理的模式,从而为病人和家属提供全面、专业的照护与支持;逐步将家庭临终护理加入医保范围,加大对家庭临终护理的政策和财力支持,普及和推广家庭临终护理;加大宣传,帮助人们更新思想观念,关注人的基本权利。     

Symptom patterns of advanced cancer patients in a palliative care unit

This study involved longitudinal evaluations of symptom severity and describes the symptom patterns of 77 terminal cancer patients (median age: 62 years; 61% female), selected from 537 consecutive patients admitted to the Palliative Care Unit of the National Taiwan University Hospital. The most common primary cancer sites in these patients were lung (23.4%), liver (15.6%), and stomach (13%). Nineteen physical and psychological symptoms were assessed using different scales. The median number of symptoms was 11 (range: 1-18) on admission, among which weakness, fatigue, anorexia, pain, and depression were the most common. A comparison of the initial symptom severity scores with those at one week after admission and two days before death suggested six symptom change patterns: A: continuous static (restless/heat, abdominal fullness, constipation, dizziness, and insomnia); B: static-increase (fatigue, weakness, nausea/vomiting, taste alteration, dysphagia, diarrhea, dry mouth, and night sweats); C: decrease-static (pain and depression); D: decrease-increase (anorexia and dyspnea); E: static-decrease (aggression); and F: gradually decrease (anxiety). These six symptom patterns can be divided into two categories on the basis of the relative severity of symptoms between one week after admission and two days before death. The first category included patterns A, C, E and F, and the symptoms improved with palliative care. However, the symptoms in the second category (patterns B and D), which were associated with the anorexia-cachexia syndrome and dyspnea, did not show improvement. As symptom management is an essential component of palliative care, holistic care, which encompasses physical, psychosocial and spiritual aspects, represents a rational approach for the relief of these incurable symptoms at the end stage of life for these patients.     

Exploring nursing outcomes for patients with advanced cancer following intervention by Macmillan specialist palliative care nurses

BACKGROUND: Little information exists about the outcomes from nursing interventions, and few studies report new approaches to evaluating the complex web of effects that may result from specialist nursing care. AIMS: The aim of this study was to explore nursing outcomes for patients with advanced cancer that may be identified as resulting from the care of a Macmillan specialist palliative care nurse. METHODS/INSTRUMENTS: Seventy-six patients referred to 12 United Kingdom Macmillan specialist palliative care nursing services participated in a longitudinal study of their care over 28 days. Patients were interviewed and completed the European Organization for Research on Treatment of Cancer Quality of Life Scale and the Palliative Care Outcomes Scale at referral, and 3, 7 and 28 days following referral to a Macmillan specialist palliative care nursing service. A nominated carer was interviewed at baseline and 28 days. Notes recorded by Macmillan specialist palliative care nurses in relation to each patient case were analysed. FINDINGS: Significant improvements in emotional (P = 0.03) and cognitive functioning (P = 0.03) were identified in changes in patients' European Organization for Research on Treatment of Cancer Quality of Life Scale scores, and in Palliative Care Outcomes Scale patient anxiety scores (P = 0.003), from baseline to day 7. Analysis of case study data indicated that overall positive outcomes of care from Macmillan specialist palliative care nursing intervention were achieved in 42 (55%) cases. STUDY LIMITATIONS: Sample attrition due to patients' deteriorating condition limited the value of data from the quality of life measures. The method developed for evaluating nursing outcomes using data from patient and carer interviews and nursing records was limited by a lack of focus on outcomes of care in these data sources. CONCLUSIONS: A method was developed for evaluating outcomes of nursing care in complex situations such as care of people who are dying. Positive outcomes of care for patients that were directly attributable to the care provided by Macmillan specialist palliative care nurses were found for the majority of patients. For a small number of patients, negative outcomes of care were identified.     

妇产科护理中相关法律问题探讨

2002年《医疗事故处理条例》以及医疗诉讼举证责任倒置有关法律的出台，使医护人员的心理压力加大。妇产科具有急诊夜诊多、病情变化快、病人周转频、工作预见性差等特点，成为医疗纠纷高发科室。作为妇产科护士除了要了解《护士管理办法》《中华人民共和国刑法》《中华人民共和国民法通则》《中华人民共和国献血法》《医疗事故处理条例》等各科通用的法律法规外，     

妇产科护理中相关法律问题探讨

2002年《医疗事故处理条例》以及医疗诉讼举证责任倒置有关法律的出台,使医护人员的心理压力加大。妇产科具有急诊夜诊多、病情变化快、病人周转频、工作预见性差等特点,成为医疗纠纷高发科室。作为妇产科护士除了要了解《护士管理办法》《中华人民共和国刑法》《中华人民共和国民法通则》《中华人民共和国献血法》《医疗事故处理条例》等各科通用的法律法规外,还必须熟读《中华人民共和国母婴保健法》《计划生育技术服务管理条例》,必须格外注重《病历书写基本规范》的学习和查对制度的执行,稍有不慎,就可导致护理纠纷,甚至医疗事故的发生…