216例老年住院患者死亡态度的调查分析

目的 了解老年住院患者的死亡态度及影响因素,为开展有针对性的死亡教育提供依据.方法 采用自行设计的"老年住院患者死亡态度调查表"对216例老年住院患者进行调查.结果 调查对象对死亡持接受态度的人数略高于持排斥态度的人数,但绝大多数人对死亡持模糊态度.患者的文化程度、患重病史、垂危患者接触史、谈论死亡情形、目前身体及心理状况影响老年住院患者的死亡态度.结论 了解老年住院患者的死亡态度及其影响因素,有助于临床有的放矢地开展死亡教育.     

住院老年患者对死亡的接受态度及其影响因素

目的：旨在了解住院老年患者对死亡的接受态度及其影响因素。方法：以住院老年患者为研究对象，使用《老年患者死亡态度调查表》进行调查。结果：住院老年患者对死亡接受持模糊态度的为70％，文化程度高、心理状态佳、有垂危患者接触史、有重病经历的患者对死亡持接受态度的比例高，分别为19．1％、36．0％、26．7％、28．6％；对谈论死亡持“尽量避免”态度的患者、患病较重、以及自我感觉身体状况较差的老年人更惧怕死亡。结论：临床有必要开展死亡教育势在必行；作为护士应在今后的工作中更多地了解老年患者对死亡的看法，根据不同的情况对老年患者进行死亡教育，提高其生活质量。     

住院老年患者死亡观及影响因素的调查分析

目的调查住院老年患者的死亡观及其影响因素,为开展有针对性的死亡教育及改善临床工作提供依据.方法采用自行设计的问卷对72例住院老年患者进行调查.结果调查对象对"生命永存观念"持否定态度的占绝大多数,也有小部分人持不确定态度.患者的文化程度、垂危患者接触史、参加葬礼情形、谈论死亡情形等因素与其死亡观相关. 结论加强研究,帮助患者减轻对死亡的恐惧和死亡阴影对其活力的限制是今后的努力方向.     

老年患者健康教育需求的调查与分析

对老年患者进行健康教育,提高老年患者自我保健能力,提高他们的生活质量是护理工作的重要内容。为此,对我院内、外科86例老年住院患者健康教育需求进行了问卷调查,现报告如下。1　对象和方法11　调查对象　选择1999年10月在我院内科(神经、内分泌、心血管、消化、呼吸、血液、肾内)和外科(肿瘤、泌尿、普外)住院的86例愿意合作的60岁以上的老年患者进行调查。12　调查内容　自行设计“老年住院患者健康教育需求问卷调查表”,内容有患者的一般情况、住院后患者最担心的问题、对健康教育内容需求的程度、教育方法及出院后对疾病相关知识的需求…     

神经科老年患者健康教育需求与教育方法

对老年患者健康教育需求进行调查,并根据调查结果提出相应的教育方法,可以满足住院老年患者健康教育的需求,提高他们的自我保健能力和生活质量。     

中年住院患者家属的死亡态度及死亡教育需求的调查

目的了解中年住院患者家属的死亡态度及死亡教育需求情况,并分析其死亡态度的影响因素。方法 2011年1-6月,采用便利抽样法选取成都市二级甲等及以上级别医院的中年住院患者家属200名为研究对象。采用死亡态度调查问卷和自行设计的《死亡教育需求调查表》对其进行调查,并分析结果。结果 131名研究对象对死亡持接受态度,69名持排斥态度。文化程度、接触死亡及濒死情况、参加葬礼次数及在家中谈论死亡情形对其死亡态度均有影响(P<0.05或P<0.01)。108名研究对象愿意接受死亡教育,最喜欢的教育方式是参加社会团体活动。结论绝大多数研究对象对死亡持接受态度,且死亡态度受多种因素的影响;死亡教育需求较高,护理人员在实施护理时,应注重死亡教育。     

老年患者健康教育需求调查及护理满意度分析

目的:探讨老年患者对健康教育内容、方式的需求,以便有针对性地提供适合于老年患者需求和特点的健康教育方法。方法:对76例住院老年患者进行问卷调查(排除脑部器质性改变引起的记忆力严重下降者),对调查结果进行统计学分析。结果:住院老年患者及其家属对健康需求普遍较高,不同文化背景患者的健康需求有所差异,实施针对性的系统健康教育与否对患者护理满意度有影响。结论:为住院患者及家属实施针对性系统健康教育可明显提高他们对护理服务的满意度。     

神经科老年患者健康教育需求与教育方法

对老年患健康教育需求进行调查，并根据调查结果提出相应的教育方法，可以满足住院老年患健康教育的需求，提高他们的自我保健能力和生活质量。     

老年高血压病患者不同住院时期健康教育的需求及护理对策

目的探讨老年高血压病患者最佳的健康教育模式，提高健康教育质量。方珐对180例住院老年高血压病患者进行问卷调查，找出住院不同阶段患者对健康教育的需求差别，加以总结分析，并提出相应的护理对策。结栗患者在不同时期对健康教育的需求存在明显差异，住院早期的主要需求为环境介绍和心理疏导；住院中期的主要需求为与药物治疗相关的知识；而出院前的主要需求则体现为对复诊及自我监测等知识的关注。结论根据不同住院时期高血压病患者健康需求进行个体化的健康教育，可达到最佳的效果，取得良好的社会效益。     

老年住院患者的心理需求调查

目的：探讨老年住院患者的心理需求,以便采取针对性的护理措施。方法：通过自行设计的调查问卷对90例老年患者的心理需求进行调查,并与80名护理人员对其认识进行比较。结果：老年住院患者存在较高程度、多维的心理需求,护理人员与老年患者在心理需求认知方面存在一定的差异。结论：要充分了解老年患者的心理需求,应通过加强心理知识培训、简化就医流程、加强护患沟通等措施以满足老年患者的心理需求。     

Provider perspectives on palliative care needs at a major teaching hospital

Jericho Metropolitan Hospital (JMH) is a major Australian teaching hospital which lacked a designated palliative care service at the time this study was conducted. A questionnaire addressing palliative care service needs, and educational and support needs of staff, was sent to 267 multi-disciplinary oncology staff at JMH. A response rate of 83% was achieved. Staff identified a number of palliative care needs that were being particularly poorly addressed by existing services. These included: spiritual support, cultural needs, grief and bereavement support, pleasant surroundings, adequate privacy and facilities for families. The majority of respondents identified the following issues as critical problems in palliative care provision: lack of a designated palliative care service, lack of palliative care education of staff, unmanageable caseloads and inadequate physical facilities for the provision of care. Only 24% of respondents reported having had any palliative care education, and 92% of respondents expressed a need for further education. The majority of respondents (79%) expressed a need for improved staff support. There was a significant association between perceived need for improved support and professional discipline (chi2 = 31.33, P < 0.002), with medical staff being significantly less likely than other staff groups to report a need for improved support. Overall, the health providers surveyed identified major deficiencies in the provision of palliative care to cancer patients at JMH and in the palliative care education and support for staff caring for terminally ill cancer patients. The findings support the need for a designated palliative care service at JMH to improve the standard of care of dying cancer patients, and the need for improved palliative care education and support for staff.     

Palliative care for frail older people: A cross-sectional survey of patients at two hospitals in England

Abstract

Background

The majority of deaths in the UK occur in acute hospitals, and older people have the highest hospital death rates. Improved palliative care for older people has been identified as an international priority, yet little is known about the profile of older patients with palliative care needs in hospitals.

Objective

To describe the profile of older hospital inpatients (≥85 years), and to explore the prevalence and nature of palliative care needs among this group.

Methods

A cross-sectional survey of palliative care need in older people was undertaken in two UK acute hospitals. Hospital case notes were examined for evidence of palliative care need according to Gold Standards Framework (GSF) prognostic indicator criteria. Patients (or consultees) completed assessments of palliative care need.

Subjects

Data were collected for 654 consenting patients/consultees. This paper describes data from 110 patients aged ≥85 years.

Results

Forty per cent of the older patients were identified as having palliative care needs according to GSF criteria. Frailty was the most common indicator of palliative care need (16.7%). The most common reason for admission to hospital was general frailty (25.5%).

Conclusions

While this study is limited by its small sample size, the results suggest that older people with frailty conditions constitute a substantial proportion of hospital inpatients with palliative care needs. However, it is unclear whether a specialist palliative care framework is the most appropriate model for this group. The care provided to older people at the end of life may best be provided by generalists such as geriatricians, as part of a comprehensive generalist-led palliative care framework.     

How many inpatients at an acute hospital have palliative care needs? Comparing the perspectives of medical and nursing staff

The primary aim of this prospective face-to-face interview survey was to identify the proportion of inpatients at an acute hospital (Royal Hallamshire Hospital, Sheffield, UK) considered to have palliative care needs by medical and nursing staff directly responsible for their care. During the 1-week period of the survey (6-10 September 1999), 452 inpatients were present in the hospital. Nursing staff were interviewed for 99% of patients; medical staff for 81%. Staff interview data were supplemented by case note review. Overall, 23% of the total inpatient population were identified as having palliative care needs and/or being terminally ill by staff and 11% were considered suitable for referral to a specialist palliative care bed. However, there was a low level of concurrence between medical and nursing staff as to which individual patients had palliative care needs (although this increased with perceived increased proximity to death), including which would be suitable for referral to a specialist palliative care bed. A need for further palliative care education for medical and nursing staff working within acute hospital settings was identified to ensure that the best use is made of hospital-based specialist palliative care services.     

A survey of commitment and compassion among nurses in residential aged care

AIM: To assess the views and attitudes of aged care staff providing direct care towards palliative care and to identify their learning needs. DESIGN: Survey design using purposive sampling methods. FINDINGS: Nurses and care assistants (n=222) employed within nine residential aged care facilities in regional Australia completed the survey. The majority had received 'on the job training' and were committed to providing end-of-life care. Differences in the level of confidence to deal with patient/family interactions and manage complex palliative care scenarios were evident between nurses and care assistants (p<0.05). Both nurses and care assistants perceived a need for further education in symptom management and communication, yet their content need differed significantly between groups. CONCLUSIONS: Nurses and care assistants in residential aged care facilities demonstrate commitment to the delivery of palliative care and express a need for increased palliative care competencies. The heterogeneity of roles and educational preparation within the aged care workforce indicate that tailored palliative care education initiatives are required to meet the learning needs of aged care nurses and care assistants, particularly in relation to end-of-life care. These data have implications for skill-mix and model of care development.     

Impact of a hospital palliative care service: perspective of the hospital staff

The first New Zealand hospital palliative care support service was established in 1985. Different service models have now been adopted by various major hospitals. In 1998, a palliative care service, funded by Mary Potter Hospice, was piloted at Wellington Public Hospital. Twelve months post-implementation, the hospital staff's views of the service were evaluated. It was found that referrals to palliative care from hospital specialities outside the Cancer Centre increased. While most doctors, nurses and social workers strongly agreed or agreed that the service positively influenced patients' care and effectively addressed their symptom management needs, spiritual needs were less often met. Over 90 percent of each discipline strongly agreed or agreed that the service had assisted them in caring for patients, but, only about a half agreed that useful discharge planning advice and staff support was provided. Significant differences in responses were found between different disciplines and specialities. One fifth of the staff identified palliative care education needs. Recommendations are made concerning the development of a future hospital palliative care service.     

综合性医院护士对安宁疗护的认知现状及培训需求调查

[目的]对某三甲综合性医院的护士进行安宁疗护认知情况及培训需求调查,为医院进一步开展相关教育、提高整体护理质量提供依据。[方法]采用罗明琴等人编制的《护理人员安宁疗护知识问卷》,以问卷星的方式发放电子问卷。[结果]护士对安宁疗护的认知总评分标准分为（71.08±15.05）,在心理护理知识方面掌握良好,在基本知识掌握方面较差。而不同的性别、年龄、学历、职称、工作年限,护士对安宁疗护认知无统计学差异（P>0.05）;不同职称、不同工作年限的护士在获取安宁疗护相关知识的途径上有差异（P<0.05）;护士对于与临终病人沟通方式和应对照护临终病人所产生的情绪压力方面培训需求较高。[结论]本院护士虽然对于安宁疗护的认知程度处于中等水平,但还是需要开展有针对性的教育培训,调动护士学习积极性,探索属于中国本土化的安宁疗护照护模式。     

Emergency medicine physicians' perspectives of providing palliative care in an emergency department

This study describes emergency physicians' perspectives on the challenges and benefits to providing palliative care in an academic, urban, public hospital in Los Angeles. Participants underwent a semi-structured interview on their training and experiences related to palliative care, perceptions of providing palliative care, and their recommendations for education and training in this area. Overall, respondents felt that palliative care is not prioritized appropriately, leading patients to be unaware of their options for end-of-life care. Providing educational materials and courses that have been developed from the ED perspective should be included in ongoing continuing medical education. Having a palliative care team that is responsive to the needs of the ED will further enhance collaboration with the ED. Future research should focus on understanding the range of benefits to having palliative care in the ED.     

晚期消化道肿瘤患者家庭主要照顾者对缓和医疗认知及态度的调查分析

目的 探讨晚期消化道肿瘤患者家庭主要照顾者对缓和医疗的认知及态度,并分析两者的影响因素。 方法 选取2018年7月-2019年7月在我院消化科住院的150例晚期消化道肿瘤患者的家庭主要照顾者为研究对象,采用缓和医疗需求度问卷对其进行调查,了解其对缓和医疗的认知和态度。 结果 晚期消化道肿瘤患者家庭主要照顾者对缓和医疗的认知率为51.33%,呈偏低状态;对缓和医疗的需求率为79.33%;Logistic回归分析结果显示,照顾者年龄、文化程度、家庭人均月收入、职业和患者年龄5个因素是家庭主要照顾者对缓和医疗认知和态度的独立影响因素。 结论 晚期消化道肿瘤患者家庭主要照顾者对缓和医疗缺乏认知,但需求度较高。这提示我们要做好缓和医疗知识的宣传工作,尤其要做好低收入、低学历人群的干预工作,促进缓和医疗的应用,以提升患者生存质量。     

Perceptions of the role of the hospital palliative care team

AIM: The aim of this study was to understand staff perceptions of the role of the hospital palliative care team and to identify knowledge and confidence levels of general staff caring for patients with palliative care needs. METHOD: A survey questionnaire tool was used with a response rate of 51 per cent. Participants included nurses, health care assistants and doctors. RESULTS: The study highlighted several misconceptions about the role of the palliative care team, but demonstrated that the clinical staff surveyed were confident in their palliative care skills, with the exception of discharge planning, despite the fact that only 26 per cent of nurses reported having undergone training in palliative care. It identified that HCAs felt confident in caring for dying patients yet had little confidence in dealing with distressed relatives or speaking to patients and families about death. It was also interesting to note that trained nurses felt confident in their symptom control skills, and they rated training in this area as one of the top priorities. CONCLUSION: The findings have considerable implications for palliative care services. Professional education should continue to focus primarily on symptom control and communication skills training, but stress management training should be considered. Staff need to be clear about how to obtain advice and what support is available for cancer patients. Further research is required to understand the needs of HCAs and potential models for education and support.     

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。