居家姑息照护对晚期癌症病人生活质量的影响

[目的]探讨姑息照护对居家晚期癌症病人生活质量的影响。[方法]将4个社区居家晚期癌症病人分为观察组39例,对照组30例。观察组进行姑息照护,对照组行常规照护。实施姑息照护前及实施1月后,用癌症病人生命质量测定量表（EORTCQLQ—C30）对病人进行评分。[结果]1个月后两组病人生活质量比较差异有统计学意义（P〈0．05）。[结论]实施姑息照护能提高晚期癌症病人生活质量。     

晚期癌症患者居家姑息照护服务现状调查及影响因素分析

近年来,癌症已成为我国城乡居民死亡的首要原因,随着老龄化社会的到来,癌症的发病率也呈逐年上升趋势。癌症患者常伴有癌痛、呼吸困难等症状的折磨,导致晚期癌症患者生活质量差,且治疗费用高,很多家庭因病致贫。被诊断为晚期或无法治愈的患者生存的可能性很小,多数癌症患者在生命晚期会选择居家治疗,目前,国外已针对晚期癌症患者广泛开展了居家姑息照护（palliativehomecare）,居家姑息照护不仅可以最大限度地缓解癌症患者疼痛、提高其生存质量,     

居家姑息照护对晚期癌症病人生活质量的影响

[目的]探讨姑息照护对居家晚期癌症病人生活质量的影响。[方法]将4个社区居家晚期癌症病人分为观察组39例,对照组30例。观察组进行姑息照护,对照组行常规照护。实施姑息照护前及实施1月后,用癌症病人生命质量测定量表(EORTCQLQ-C30)对病人进行评分。[结果]1个月后两组病人生活质量比较差异有统计学意义(P<0.05)。[结论]实施姑息照护能提高晚期癌症病人生活质量。     

姑息治疗提高晚期癌症患者生活质量

目的：探讨应用姑息治疗对提高晚期癌症患生活质量（quality of life,QOL)的影响。方法：对96例晚期癌症患进行姑息治疗，采用QOL观察指标对本组病例治疗前、后评分，将QOL分为好≥41分；中21－40分；差≤20分共3个等级进行评估。结果：本组病例QOL评分，治疗前≤40分，治疗后≥41分为71例；治疗前≤20分、治疗后≥21分为12例；治疗前后无效13例。QOL提高占86％，无效为14％。结论：姑息治疗能提高晚期癌症患的QOL。     

晚期癌症姑息治疗患者焦虑及相关因素

目的 探讨晚期癌症姑息治疗患的焦虑及相关因素，以制订更加合理的心理康复措施，提高生存质量。方法 选用焦虑自评量表（SAS）评价病人的焦虑情绪。采用卡氏功能量表（KPS）、疼痛问卷（VRS）、医学应对方式（MCMQ）、社会支持量表等作为相关因素，对50例晚期癌症姑息治疗病人进行评定。结果 晚期癌症姑息治疗患的SAS评分明显高于常模；多元回归分析显示：SAS评分与疼痛程度正相关，与支持利用、面对、年龄负相关。结论 姑息治疗的晚期癌症患存在较多的焦虑，并受多种因素影响，应有针对性地给予帮助和指导。     

整合姑息照护的研究进展

随着医学模式的转变,姑息照护正在迅速获得主流医学实践的认可,越来越多的证据支持融入医学实践,整合姑息照护是一个抽象而复杂的问题。本研究对整合姑息照护的内涵、模式及效果等内容进行综述,以期为开展进一步研究提供参考。     

晚期癌症姑息治疗患者焦虑及相关因素

目的探讨晚期癌症姑息治疗患者的焦虑及相关因素,以制订更加合理的心理康复措施,提高生存质量。方法选用焦虑自评量表(SAS)评价病人的焦虑情绪。采用卡氏功能量表(KPS)、疼痛问卷(VRS)、医学应对方式(MCMQ)、社会支持量表等作为相关因素,对50例晚期癌症姑息治疗病人进行评定。结果晚期癌症姑息治疗患者的SAS评分明显高于常模;多元回归分析显示:SAS评分与疼痛程度正相关,与支持利用、面对、年龄负相关。结论姑息治疗的晚期癌症患者存在较多的焦虑,并受多种因素影响,应有针对性地给予帮助和指导。     

晚期老年痴呆症患者姑息照护的研究进展

老年痴呆症是指老年老化程度超过生理老化或过早老化,致脑功能障碍,引起获得性、持续性智能障碍。     

灵性照护在晚期癌症患者中的研究进展

【】 综述了灵性的相关概念,晚期癌症患者灵性需求评估及需求现状,通过意义疗法、尊严疗法、宗教疗法等多方面可以满足患者的灵性需求,从而提高患者生活质量、改善患者心境、节约医疗资源等。但是目前我国临床开展灵性照护还面临诸多问题,因此有待进一步探索适合我国国情的灵性照护模式。     

护士安宁护理自我效能及其影响因素的调查分析

目的探讨护士安宁护理自我效能情况及其影响因素。方法采用方便抽样方法,选择260名护士,采用护士安宁护理自我效能调查问卷进行调查。结果影响护士安宁护理自我效能的主要因素是对死亡态度、过去所在科室、护理终末期病人的经验、自觉重要程度。护士过去经验和对安宁护理的自觉重要程度与自我效能呈正相关（均P〈0.001）。结论增加护士照护经验积累,提高心理与灵性照护能力,重视安宁护理的教育及培训,对提高安宁护理质量具有积极的意义。     

临终反向关怀在晚期癌症患者中应用的研究

目的 探讨临终反向关怀在晚期癌症患者中的应用.方法 选取2018年3月—2020年3月某市宁养院服务的临终患者60例,将不同病区治疗的患者分为对照组及试验组,每组各30例.对照组患者实施常规护理,试验组患者反向关怀干预,即临终患者作为主体对亲友、同事、照护工作者等客体做出的关心慰藉活动,干预时间1个月,比较两组临终患者...     

老年鼻咽癌病人家庭照护者对缓和医疗需求及相关因素分析

[目的]了解老年鼻咽癌病人家庭照护者对缓和医疗需求的现状,分析相关因素。[方法]采用简单随机抽样法,于2018年2月—2019年8月选取广西医科大学附属第一医院老年鼻咽癌病人的家庭照护者为研究对象。采用自行设计的问卷,调查家庭照护者的一般资料及对缓和医疗的需求情况,分析影响家庭照护者对缓和医疗需求因素。[结果]老年鼻咽癌病人家庭照护者对缓和医疗需求总分为(89.11±14.78)分,其中以照护者精神心理需求的得分指标最高;拟合多元线性回归分析结果显示,年龄、有无照护经验及与病人关系是影响家庭照护者对缓和医疗需求的独立因素(P<0.05)。[结论]老年鼻咽癌病人家庭照护者对缓和医疗需求程度高,且需求愿望与照护者年龄、有无照护经验及与病人关系有关,应具有针对性进行专业知识宣教及心理健康教育,有助于改善家庭照护者的心理状态,优化病人的生活质量。     

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。     

Factors influencing preferences for place of terminal care and of death among cancer patients and their families in Korea

Goals of work This study examined cancer patient and family member preferences—and the reasons for the preferences—regarding place of terminal care and of death.Patients and methods We constructed a questionnaire that included demographic, clinical, and support network data for 371 patients who were treated at any of the seven university hospitals or the National Cancer Center in Korea and 281 of their family members.Main results About half of the interviewed patients and half of the family members expressed a preference for the patient being cared for and dying at home. The preference reflected a wish for patients to live out their lives in privacy and to be with their family when their life ended. Those who expressed a preference to be cared for or to die in a hospital wanted to get medical treatment during the last days of life and to relieve their families of the burden of caring for them. Of the variables examined, support network factors and some sociodemographic factors (sex, family members age, and place of residence) were strongly predictive of preferences.Conclusion A majority of cancer patients preferred to receive terminal care at home. Cancer patients and family members with strong support groups were more likely to prefer the home as the place of terminal care and dying. Hence, improving support networks might increase the proportion of patients receiving home care and dying at home.     

Childhood sexual abuse in advanced cancer patients in the palliative care setting

Childhood sexual abuse (CSA) is a common, distressing, yet rarely discussed topic in palliative care. The long-term effects of CSA can have a significant impact on patients’ quality of life, particularly at the end of life. In this article, we aim to initiate a discussion regarding the need to address CSA in the palliative care setting, using the example of an advanced cancer patient and her caregiver sister who revealed their common past. Specifically, we will be discussing 1) the comorbidities, psychological distress, and family distress associated with CSA, 2) its impact on health care delivery, 3) an approach to initiating conversations regarding CSA, and 4) various management strategies. Successful management of CSA necessitates an interprofessional team approach and may help to improve the quality of life of patients and their families.     

Palliative sedation in a specialized unit for acute palliative care in a cancer hospital: comparing patients dying with and without palliative sedation

Palliative sedation is undergoing extensive debate. The aims of this study were to describe the practice of palliative sedation at a specialized acute palliative care unit and to study whether patients who received palliative sedation differed from patients who did not. We performed a systematic retrospective analysis of the medical and nursing records of all 157 cancer patients who died at the acute palliative care unit between 2001 and 2005. Palliative sedation, defined as continuous deep sedation prior to death, was used for 43% of all deceased patients. In 87% of the sedated patients, it was started in the last two days before death. Sedated and nonsedated patients did not differ in survival after admission (eight days vs. seven days, P = 0.12). Sedated patients were younger (55 years vs. 59 years, P = 0.04) and more often had malignancies of the digestive tract (P < 0.01). In both groups, common symptoms at admission were pain (79% vs. 87%, P = 0.23), constipation, (40% vs. 48%, P = 0.46), and dyspnea (32% vs. 29%, P = 0.77). On the day that palliative sedation was started, sedated patients more often suffered from dyspnea and delirium than nonsedated patients at a comparable day before death. The most important indications for palliative sedation were terminal restlessness (60%) and dyspnea (46%). We conclude that at the studied acute palliative care unit, patients who ultimately received palliative sedation did not have symptoms different than nonsedated patients at admission, but on the day at which the sedation was started, they suffered more often from delirium and dyspnea.     

Quality of life of cancer patients receiving inpatient and home-based palliative care

AIMS: This paper reports a comparative study of the symptom experience, physical and psychological health, perceived control of the effects of cancer and quality of life of terminally ill cancer patients receiving inpatient and home-based palliative care, and the factors that predict quality of life. BACKGROUND: Quality of life is a major goal in the care of patients with terminal cancer. In addition to symptom management, psychological care and provision of support, being cared for at home is considered an important determinant of patient well-being. A more comprehensive understanding of the impact of cancer on patients and their families will inform the delivery of palliative care services. METHODS: Fifty-eight patients with terminal cancer (32 inpatients, 26 home-based) were recruited from major palliative care centres in Australia in 1999. A structured questionnaire designed to obtain sociodemographic information, medical details and standard measures of symptoms, physical and psychological health, personal control and quality of life was administered by personal interview. RESULTS: The two groups were similar on most demographic measures, although more home-care patients were married, of Australian descent and had private health insurance cover. The most prevalent symptoms reported were weakness, fatigue, sleeping during the day and pain. Patients receiving home-based services had statistically significantly less symptom severity and distress, lower depression scores, and better physical health and quality of life than those receiving inpatient care. Home-care patients also reported statistically significantly more control over the effects of their illness, medical care and treatment received, and the course of the disease. Multiple regression analyses showed that better global physical health, greater control over the effects of cancer and lower depression scores were statistically significant predictors of higher quality of life. CONCLUSIONS: The main issues arising from the findings for nurses are the early detection and management of both physical and psychological symptoms, particularly fatigue, pain, anxiety and depression, and the need to use strategies that will empower patients to have a greater sense of control over their illness and treatment. Research is needed to identify other factors that may impact on quality of life, and to establish the extent to which inpatient and home-based care meets the needs of both the patient with terminal cancer and their family.     

癌症照护质量影响因素的研究进展

从癌症病人因素、提供者水平因素及健康系统因素3方面综述了癌症照护质量的影响因素.指出护理工作者作为癌症病人的重要支持者和照顾者应重视影响癌症病人照护质量的因素,从而选择更为有效的护理措施和护理模式,以提高癌症病人生活质量.